LITTLE ROCK, Ark. — Many people are looking for new doctors to start 2024 as Arkansas's most prominent private nonprofit healthcare provider is out of network with a significant insurance payor.
Baptist Health finalized agreements for 2024 with all but one of the largest payors in the state – UnitedHealthcare.
"I'm not sure what we will do if they don't figure this out quickly," Baptist Health Patient Kate Bueche said.
Buche hopes the disagreement is temporary, but UnitedHealthcare doesn't cover her and many Arkansans at Baptist right now.
And she found out Tuesday during her appointment.
"They just informed me that I might have to pay for it out of pocket," Bueche said. "I don't have much of a choice at this point."
Bueche and her husband still plan to attend their appointments this month because they're a high priority.
"When you've got medications that not only help your quality of life, but in some cases help keep you alive... that's a problem to have to start over," Bueche said.
Bueche said she might have to explore options elsewhere to get doctors in-network. However, she plans to reach out to UnitedHealthcare to see if she can get a continuation of care.
A spokesperson with UnitedHealthcare issues a statement on the matter:
“Baptist Health is approximately 20% higher cost compared to other peer hospitals throughout the state, yet the health system proposed a one-year, 15% price hike and recently communicated to us it would also be seeking a double-digit rate increase in the second year of our contract," UnitedHealthcare said. "We have proposed a multi-year contract that includes meaningful rate increases that ensure Baptist is reimbursed at more than fair and reasonable rates. We ask that the health system either finalize the terms of our proposal or provide a reasonable proposal Arkansans and local employers can afford.”
Baptist Health also released a statement regarding the failed agreement with UnitedHealthcare:
"For more than five years, Baptist Health has been open and transparent with Arkansas insurance payors regarding the economic challenges facing Arkansas hospitals," Baptist Health said. "These challenges are largely driven by Arkansas hospitals having the lowest overall reimbursement rates in the nation by a significant margin. During this time, Baptist Health has actively engaged with insurance payors to develop a mutual understanding of the underlying challenges, so we could then focus our efforts on a path toward addressing the nationally low reimbursement rates. Baptist Health recognizes this issue will not be fixed overnight; however, the unprecedented rise in costs such as wages, supplies and pharmaceuticals that occurred post-pandemic meant that we could no longer accept nationally-low reimbursement rates and sustainably deliver high-quality healthcare for the communities we serve. The good news is we finalized agreements for 2024 with all but one of the larger payors in Arkansas. Unfortunately, UnitedHealthcare has taken a different approach and is posting what Baptist Health believes is misleading and negative information that does little to address the undisputed reimbursement challenge that has developed over many years. As a result, all Baptist Health locations, services and providers are out of network with UnitedHealthcare insurance effective on Jan. 1, 2024. UnitedHealthcare has an offer on the table from Baptist Health that includes reimbursement rates that meet immediate needs, are still well below the national average, and are below what UnitedHealthcare already pays to other hospitals in surrounding cities such as Texarkana, Springfield, Shreveport, Monroe, Tulsa and Memphis. Any patients with UnitedHealthcare, whether a commercial plan or Medicare Advantage plan, should contact UnitedHealthcare to confirm coverage and out-of-pocket costs before seeing a Baptist Health provider. Patients not sure of network coverage can still schedule an appointment with Baptist Health but should be aware of the possible change in out-of-pocket cost for using an out of network provider. Generally, UnitedHealthcare can best answer any of their members' questions about what providers are still in network and specific changes in costs to the member going into 2024."
You can find information regarding the next steps for United members here.