Premier, UnitedHealthcare reach agreement on major issue

April 29--Premier Health and UnitedHealthcare (UHC) have crossed a major barrier in their ongoing negotiations to reach a contract agreement that would preserve health plans for thousands of Dayton-area residents.

Dayton-based Premier Health, the largest health system in Southwest Ohio, and UHC, the nation's largest health insurer, have agreed to extend Medicare Advantage coverage until the end of this year for UHC members who use Premier hospitals and providers, Premier said late Friday.

However, the two sides remain at odds over a key issue with the first deadline for a portion of their contract set to expire at Midnight Saturday, potentially displacing tens of thousands of local residents with individual and employer-sponsored health plans.

Unless an agreement is reached, those policy holders would no longer have access to Premier hospitals as part of the insurance company's network.

Premier physicians would also be considered out-of-network on May 14 for employer-sponsored, individual and Medicaid plan members, according to UHC. And Premier hospitals and physicians would be out-of-network for Medicaid plans starting May 14, if an agreement is not reached.

All toll, about 70,000 residents would be impacted in the local area, according to UHC, which said Premier's decision not to participate in the insurer's plan design, which ranks hospitals and providers in tiers based on cost and quality, was the sticking point in the ongoing negotiations.

Premier objects to the "tiering" system because, company officials said, it would intentionally steer patients away from Premier providers.

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