Dive Brief:
- UnitedHealthcare, which insures 417,000 people in North Carolina, is set to drop all Carolinas Healthcare System providers from its network beginning Feb. 28.
- The two are said to be continuing contract negotiations but do not appear close to reaching an agreement, says the Post and Courier.
- UnitedHealthcare says Carolinas is asking for a reimbursement increase that is "above the market average without any commitment to the quality or value it provides our customers," the paper reports.
Dive Insight:
UnitedHealthcare offered to pay the hospital system "rates that are similar to what other health plans pay them for the same services," says spokesman Daryl Richard. An estimated 10,000 consumers will be impacted by the split.
As the Post and Courier notes, none of this is unprecedented, as insurers try to reign in costs by narrowing networks to those providers that return the best combination of results and prices.
The paper quotes a 2014 report by America's Health Insurance Plans that concludes, "The use of high-value provider networks is one of the tools used by health plans to reduce costs and provide high-quality and cost effective care for consumers." The report determined that premiums were 5% to 20% lower for plans with narrow networks vs. those with broad networks.