A big Manhattan hospital system and one of the country’s largest insurers have failed to come to terms on a contract, potentially forcing thousands of New Yorkers to find new hospitals and doctors, or face higher healthcare costs.
Continuum Health Partners-which includes Beth Israel Medical Center, St. Luke’s-Roosevelt Hospital Center, Long Island College Hospital and the New York Eye and Ear Infirmary-dropped out of UnitedHealthcare’s network on January 1.
The contract termination affects about 24,000 United members who have accessed Continuum over the past 12 months. That includes some 12,000 United participants in self-funded accounts, groups that self-insure their own health costs but hire United to administer the health benefits. Another contract with Continuum covers another 12,000 insured members. These insured customers-mostly enrollees in United’s Oxford Health Plans unit-continue to be covered in-network until March 1. United also is treating all Medicare and Medicaid beneficiaries as in-network until March 1.
Unlike the insured members, United’s self-insured groups do not fall under New York state’s mandated two-month cooling off provision. The regulation extends in-network coverage to people whose health plans end a contractual relationship with their current hospital or doctors to give them time to sort out new providers.
United said in a statement that it is “doing everything we can to minimize the disruption and inconvenience for our employer groups, plan participants and physicians. Not a single person will loose healthcare coverage because of the Continuum contract termination, although some people will have to change hospitals or physicians.”
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2 Responses
This is a business decision made by 2 parties. Their customers have a choice whether they will want to go ‘out of network’ and have treatment in these hospitals or stay ‘in network’ & go elsewhere.
The answer IS NOT government involvement in health care!!
Whether these hospitals can truely be called “private” is questionable. A NGO providing a unique service financed in large part by the public fisc is not quite the same as a corporation owned by shareholders whose money is at risk.
The insurance company is a private entity, but again, the government is so heavily involved that it is hardly an exemplar of capitalism. Also, once the “insurance” company has to pick hospitals for the patients, it becomes a health care provider rather than an insurer.
The solution might lie in a system that lets people make choices with their own money, while guaranteeing a minimum that doesn’t undermine public health. Don’t expect the Democrats to come up with one. They can’t even figure out the right questions to ask.