Carson Tahoe working with state on United health insurance issue

Carson Tahoe Health and state of Nevada officials are navigating the fallout from an Aug. 14 announcement that CTH would not renew its contract next year with United Healthcare – the health insurance company used for state employees.

The announcement was made in a letter apparently signed by Carson Tahoe President and CEO Michelle Joy and addressed to community members.

"CTH is committed to remaining your independent local provider of quality healthcare. To do so, we have been forced to make an extremely difficult decision. When our contract with United sunsets on May 30, 2025, we will not renew it and CTH will no longer remain in contract as an 'in-network' provider for United," reads the letter.

It then addresses how the decision will affect those who use United for health insurance. Carson Tahoe Health serves Carson City, Douglas, Lyon and Storey counties, but sees patients from as far away as Mammoth Lakes, Calif., and Elko, according to CTH officials.

"As of May 31, 2025, services provided by CTH and its providers will be considered out-of-network under United's insurance plans. Services provided prior to May 30, 2025 will not be impacted," the letter says. "After May 31, 2025, community members insured by United may still choose to see CTH providers and seek care at a CTH facilities, but it may be at a greater cost based on the coverage provided by their United insurance plan.

"Rest assured that if you visit CTH for emergency services, federal law requires services be provided and reimbursed at the in-network rate for those with health insurance through an employer, the federal health insurance marketplace, a state-based marketplace or other individual market coverage."

To remain in-network with CTH, the letter says, "Our hope is that with this advance notice, employers and individuals will have time to explore and choose from a variety of insurance options that remain in-network with CTH and continue to operate with us as partners in care."

CTH and state officials confirmed with the Appeal they were working to navigate the situation.

"The Office of the Governor and Department of Administration are aware of the contract renewal issues between United Healthcare and Carson Tahoe Health. State leadership have meetings scheduled with both parties to help navigate this issue," said Elizabeth Ray, spokesperson for Gov. Joe Lombardo.

According to the Carson City Chamber of Commerce, government (state and local) employs over 11,500 in the city. The largest employers include the Nevada National Guard and state departments of corrections, transportation and employment security. Carson Tahoe Health, a nonprofit, is also one of the city's largest employers.

"Over many of these years, we have partnered with United Healthcare and gratefully provided you with nearby care that is easily accessed," reads the CTH letter. "Increasingly however, we are reliant upon the decisions of insurance companies for care and livelihood. The complexities of navigating insurance claims is growing, reimbursements are declining, and every day on the front lines this translates into increasing insurance authorization denials and possible delays in physician-directed treatments, as well as payment barriers making an ongoing relationship insurmountable."

The letter further states: "We understand that making decisions on healthcare and insurance for you and your family can be extremely challenging. Please know that CTH truly regrets the decision to forgo renewal of its contracts with United. However, our long-term sustainability and ability to remain an independent community provider has forced this decision. That said, we are holding every hope that we can find a sustainable path forward, together."

United Health Group, which runs United Healthcare, reported revenues of $371.6 billion and earnings from operations of $32.4 billion in 2023, according to a news release from the company.

Cole Manbeck, United Healthcare director of corporate communications, sent the following statement to the Appeal:

"Our goal is to utilize the more than nine months remaining on our contract to engage in good-faith negotiation in an effort to renew our relationship so the people we serve have long-term access to Carson Tahoe Health. We hope they share our commitment toward reaching an agreement."