Brown University Health, UnitedHealthcare fail to reach agreement. What it means

Patients covered by UnitedHealthcare’s Medicare Advantage plans will no longer find their insurance accepted at Brown University Health’s hospitals in Rhode Island starting July 1.

The change comes after the insurer and Rhode Island’s largest health system failed to reach an agreement to renew their contract after months of negotiation.

“In addition to a modest reimbursement rate increase to cover the costs of caring for their members, we asked United to eliminate their administrative policies that deviate from traditional Medicare, such as unnecessary prior approval and utilization management, that cause frustration for patients and result in extra cost to our health care system,” a statement provided by Brown Health spokesperson Jessica Wharton said.

 “Since both parties held firm in their positions, we mutually decided to end our Medicare Advantage hospital contract effective June 30, 2025,” the statement added.

UHC, however, disputes Brown Health’s version of events.

“We proposed extending our contract through the end of the year to provide Medicare Advantage members continued access to Brown University Health’s hospitals while we negotiate. Unfortunately, the health system refused and continues to seek price hikes that would make them significantly higher cost than any hospital in our Medicare Advantage network in Rhode Island,” said a statement provided by UHC spokesperson Cole Manbeck.

“We urge Brown University Health to share in our commitment toward reaching an agreement that is affordable so people enrolled in Medicare Advantage plans have continued network access to its hospitals,” the statement continued.

UHC also stated it is still negotiating with Brown Health, but Wharton said negotiations had finished.

What does this mean for UHC Medicare Advantage members?

Starting July 1, patients covered by UHC Medicare Advantage plans, including Dual Special Needs Plan (DSNP) and Group Retiree plans, coming to Brown Health’s hospitals in Rhode Island – which include Rhode Island Hospital, the Miriam Hospital, Newport Hospital and Hasbro Children’s Hospital – will be considered out of network, which will likely result in greater charges for receiving health care services.

UHC stated that under 20,000 members will be impacted by the change.

One exception is people enrolled in UHC’s Group Retiree PPO plan, which will still consider Brown Health as an out-of-network provider, but their cost will be the same as if they were in network.

The change does not apply to Brown Health’s hospitals in Massachusetts – Morton Hospital in Taunton and Saint Anne’s Hospital in Fall River – which are under a separate agreement and where those patients will still be considered to be in network.

Brown Health physicians will also continue accepting UHC’s Medicare Advantage plans.

Both UHC and Brown Health stressed that patients who use the hospitals in Rhode Island for emergency services should still be covered by the insurer.

This article originally appeared on The Providence Journal: Brown University Health, UnitedHealthcare fail to reach agreement. What it means