CT health care system and insurance company at odds in contract negotiations

A Connecticut health care system and an insurance company are at odds in contract negotiations, with the insurance company informing customers that the contract ends on July 1.

The Courant learned of the ongoing contract negotiations and points of disagreement from United Healthcare customers who shared letters received from the company about the deadline for the contract to end.

A spokesperson for Trinity Health Of New England who was asked about the negotiations and points of contention, said in an emailed statement that Trinity “is committed to working with UnitedHealthcare to reach a fair agreement that appropriately covers the true cost of the care we provide to our patients in Connecticut and Massachusetts who have UnitedHealthcare commercial and Medicare Advantage plans. Our current agreement ends June 30, 2024, for all Trinity Health Of New England hospitals and facilities.”

Trinity noted in an online post about the negotiations that the July 1 expiration of the agreement impacts in-network access to these Trinity Health Of New England hospitals, facilities, and health care providers:

• Saint Francis Hospital – Hartford, CT
• Mount Sinai Rehabilitation Hospital – Hartford, CT
• Saint Mary’s Hospital – Waterbury, CT
• Johnson Memorial Hospital – Stafford Springs, CT
• Mercy Medical Center – Springfield, MA

“As of now, we remain in-network and nothing changes. Patients who have UnitedHealthcare insurance should continue scheduling appointments and receiving care at Trinity Health Of New England hospitals and facilities,” the Trinity spokesperson said.

But the spokesperson also noted a point of contention in the talks, saying, “Unfortunately, despite UnitedHealth Group (United Healthcare’s parent company) making record profits of $22 billion last year, UnitedHealthcare has not offered a contract that puts patients’ health over their own wealth. We believe everyone deserves access to high-quality health care. That’s why we are determined to protect patients’ access to Trinity Health Of New England and push for what’s right, so we are here to care for the next generation.

“As a not-for-profit health system, rising supply and labor costs have made it difficult to maintain the services and convenience patients deserve. We are doing our best to adapt and innovate, but we rely on fair reimbursement to keep our doors open. Without it, we cannot provide the care and services patients depend on and need,” the spokesperson said.

She added, “We encourage patients to call UnitedHealthcare or ask your employer to let UnitedHealthcare know that it is important to protect your access to Trinity Health Of New England and its providers.”

The spokesman for United Healthcare confirmed the company is in active negotiations with Trinity Health of New England and has a goal to renew the relationship and ensure continued access to the health system at an affordable cost.

The spokesman also was critical of Trinity over its proposal.

“Trinity Health of New England issued a notice to end our contract and is demanding a more than 30% price hike that would take effect over the next 24 months for our employer-sponsored plans, significantly driving up health care costs for Connecticut and Massachusetts families as well as employers,” the United Healthcare spokesman said.

“Our goal is to reach an agreement that is affordable for the people and employers we serve and we have proposed meaningful rate increases that help ensure the health system continues to be reimbursed at market-competitive rates. We continue to urge Trinity to approach the negotiation with a realistic proposal that is sustainable for consumers.”

If no agreement were reached, all of Trinity Health of New England’s hospitals, facilities and its physicians would be out of network for these benefit plans, effective July 1, 2024: Employer-sponsored and individual commercial plans; Medicare Advantage plans, including Group Retiree; and Medicaid plans, including Dual Special Needs Plan, according to the spokesman

According to the United Healthcare spokesman, the Trinity proposal would increase health care costs by approximately $33 million for employer-sponsored commercial plans and are more than double the annual cost growth benchmarks set by the Connecticut Office of Health Strategy.

OHS established a healthcare cost growth benchmark target of 2.9% for 2024 and recently raised the benchmark to 4% for 2024 to account for inflationary trends, according to United Healthcare.

“Our goal is to reach an agreement without any disruption to the families we serve. We continue to urge THNE to join us at the negotiating table with a reasonable proposal that’s affordable and sustainable for the residents and businesses we serve throughout Connecticut and Massachusetts,” United Healthcare said in an online post.

Trinity said in an online post, “Patients, continue to visit Trinity Health Of New England hospitals, facilities and physicians as you normally would. Though negotiations are a routine part of doing business, UnitedHealthcare is unfortunately misrepresenting the situation and not putting patients first. They continue to not reimburse us fairly and deny or underpay claims, so they can use those dollars to bolster their own pockets and those of their shareholders.”