100,000 patients could lose access to doctors at Houston Methodist hospitals due to insurance company’s contract dispute

HOUSTON – A hundred-thousand people insured by UnitedHealthcare are scrambling to find new doctors and hospitals after the insurance company and Houston Methodist Hospital could not come to terms over reimbursement rates.

The contract expired at midnight, meaning the seven Houston Methodist hospitals and its outpatient clinics are no longer in-network as of Jan. 1, 2020.

Donna Thompson of Baytown has been insured by UHC for 12 years.

“I just figured they’d work it out, why wouldn’t they?” Thompson said.

Houston Methodist's Baytown location is the only hospital in that city.

"90%, probably more than that, of the doctors (in Baytown) are Methodist doctors," Thompson said.

She'll now have to drive to Houston to find new providers.

“I’m not that upset with Methodist. I don’t pay Methodist hundreds of dollars a month in premiums out of my husband’s paycheck. We do UHC and they should make it easier for us when we don’t have a choice,” Thompson said.

Employers were also caught off guard by the dispute between the healthcare giants.

"It's going to mean significant changes for me and my staff and all of our families," said Anna Coffey, chief executive officer of The Women's Home.

Coffey said she switched to UnitedHealthcare for the non-profit’s employee health plan less than a year ago.

“My main question when we were looking at switching was whether Methodist was in-network and I was told yes. I feel like it was a bait and switch,” Coffey said.

Coffey said she plans to drop UnitedHealthcare and find a new insurer.

UnitedHealthcare released the following statement:

“Care at Houston Methodist Hospital is significantly more expensive than care at other top-ranked hospitals in Texas as well as some of the most prestigious hospitals in the entire country. Every time we attempted to reach a compromise during the negotiations, Methodist responded with proposals showing that it is intent on maintaining its position as one of the most expensive health systems in the country.

"It’s unfortunate that Methodist has been unwilling to actively participate in meaningful negotiations or to acknowledge that it’s driving up the cost of health care for the people of Houston and the health care system overall. Instead Methodist has chosen to spend its time and money blanketing the airwaves with ads and erecting billboards.

"Our members can rest assured that they will continue to have access to high-quality, affordable care from the more than 90 hospitals and thousands of primary care physicians and specialists who are part of our Houston-area network. Our top priority is supporting our members as they transition to new care providers and ensuring they have uninterrupted access to the care they need.”

Houston Methodist Hospital released the following statement:

"Houston Methodist had a contract in place with United for 21 years before they abruptly gave notice of termination a few months ago, creating confusion among our 100,000 patients insured by United. Although Houston Methodist negotiated in earnest, an agreement was not reached by the Jan. 1, 2020 deadline and now those Medicare Advantage and commercial patients must search for new doctors and new facilities.

"It’s obvious that UnitedHealthcare is more concerned with its bottom line than with thousands of patients having access to the No. 1 hospital in Texas.

"We could not accept the insurance company’s proposed cuts and compromise the high-quality care we provide our community. During the negotiation, United continued to demand significant cuts to rates that it previously negotiated with us.

"We are disappointed by United’s actions -- but not surprised given its aggressive actions against providers across the country. United’s unfortunate decision – and disruption to their members’ in-network access to Houston Methodist -- is forcing employers and consumers to pick different health care options for this year. Every step of the way, this has been about the patients for us, and the money for United.

"As of today, patients with United insurance are encouraged to use our facilities and doctors if they have out-of-network benefits, and they are always welcome to seek emergency care in our hospitals or stand-alone emergency room centers. Patients undergoing treatment right now should call United about continuing their services.

“We do not expect a significant change in our operations as there is a high demand for our services in Houston. We just wish United’s patients could still have the choice to pick us for their medical care.”

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