UHealth, United have a deal. What Medicare Advantage, other patients should know

The University of Miami Health System and UnitedHealthcare have reached a deal that will let thousands of patients who are insured through United continue to receive in-network care with UHealth doctors.

United and UHealth confirmed the agreement to the Herald early Friday afternoon. The new multi-year agreement will keep UHealth in-network for people who are part of United’s network through an employer-sponsored commercial plan, Medicaid (United Healthcare Community Plan of Florida) or “Individual Family Plans” purchased through the Affordable Care Act (ACA) Marketplace, also known as Obamacare.

UHealth and United, whose parent company is UnitedHealth Group, are still negotiating a separate contract that will determine whether the private health system will remain in-network for Medicare Advantage members in Miami-Dade and Broward counties who are insured through Preferred Care Network, a United company.

The two health giants have until the end of August to secure a new PCN contract. If a new deal is not made, UHealth would go out-of-network for PCN’s Advantage members starting Sept. 1., according to United.

UHealth has previously told the Herald it’s “trying to negotiate” with United to extend coverage until the end of the year for over 26,000 of its patients who are enrolled in a PCN Medicare Advantage plan. January is when open enrollment begins for Advantage plans.

People with Medigap plans will still be able to receive care at UHealth, regardless of the negotiations’ outcome, according to United.

Friday’s deal is a win for UHealth patients insured with United, the largest health insurer in the nation. The renewed multi-year contract goes into effect immediately, which means United members will not see any changes to their care and will continue to get in-network care across UHealth, including at the renowned Sylvester Comprehensive Cancer Center and Bascom Palmer Eye Institute.

“We look forward to continuing to serve families throughout South Florida who rely on us for access to quality, affordable care,” United told the Herald in a Friday statement.

UHealth had similar words Friday.

“We’re pleased to have reached a new agreement that ensures patients and their families can continue accessing the UHealth doctors, hospitals, and services they know and trust. Throughout the process, our priority has been to protect patient access, avoid disruptions in care, and keep high-quality care accessible,” UHealth told the Miami Herald in a statement. “We appreciate that United saw the value of maintaining access to academic medicine for the thousands of patients who rely on us for their complex care.”

Friday’s deal was finalized in the final hours before a deadline that would have kicked UHealth off United’s network. Last-minute negotiation breakthroughs are common with health insurance-related contracts. Health insurers and hospitals tend to keep their contracts confidential, but, judging from each party’s previous comments, disagreements over reimbursement rates were a key issue throughout the negotiations.

This is only the latest South Florida hospital-versus-health-insurer dispute to go public. Thousands of people insured through Florida Blue, one of the largest health insurers in the state, are still out-of-network at Broward’s two public hospitals due to stalled contract negotiations. Broward Health and Memorial Healthcare System have accused Florida Blue of not paying them enough for care, while the health insurer is accusing them of wanting too much money. Negotiations in that dispute remain ongoing.

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