ER staffing firm Envision Healthcare and insurer UnitedHealthcare have settled on a nationwide contract extension following months of public squabbling.
All UnitedHealthcare plan participants will have in-network access to Envision's more than 25,000 emergency department physicians, anesthesiologists and other clinicians under the terms of the agreement.
The armistice on Tuesday quells fears over a contract impasse. If that had happened, UnitedHealthcare's 27 million insured patients could have faced expensive surprise medical bills as early as Jan. 1, when Envision doctors were slated to become out-of-network.
The fight between the two giant for-profit companies put patients directly in the crossfire. It can be very difficult for patients to avoid using out-of-network doctors in emergency situations.
A Kaiser Family Foundation poll in early September found that 67% of people worry about unexpected medical bills. According to NORC, 57% of Americans have been hit with a surprise medical bill in the past. Some 20% of those bills were due to a doctor being out-of-network.
Capitol Hill has taken note. In September, a bipartisan group of senators unveiled legislation designed to prevent medical bankruptcies from surprise billing practices.
Though disputes over reimbursement between insurers and providers are relatively common, the standoff between UnitedHealthcare and Envision was particularly high-stakes.
That's partially due to the size of both companies.
Nashville-based Envision has more than 25,000 clinicians in 45 states and D.C. and is one of the country's largest physician staffing groups. Minneapolis-based UnitedHealthcare covers roughly 27 million Americans through its private medical plans.
UnitedHealthcare told Bloomberg this month that about 650,000 of its members received care from Envision clinicians in 2017 alone.
Though the roots of the contract dispute stretch back to 2009, the conflict received intense public scrutiny in recent months.
Envision filed a lawsuit against UnitedHealthcare in March over alleged payment failures. A judge dismissed the suit in April but the dispute bubbled over again in September, when UnitedHealthcare sent a letter to more than 250 hospitals informing them it was considering dropping Envision starting in the new year.
In October, the battle went online. UnitedHealthcare set up a now-defunct website accusing Envision of charging higher prices for its emergency services. Envision followed suit with its own site, blaming insurers for gaps in patient coverage that leave them exposed to surprise bills.
It seems all is once again rosy between the couple, however, following the agreement.
"We believe this is an opportunity for clinicians and payors to work together to make progress toward a more effective healthcare system," Christopher Holden, president and CEO of Envision, said in a statement.
The announcement comes a day after nine prominent healthcare organizations announced their support of federal legislation to protect patients from surprise medical bills. The coalition, which includes America's Health Insurance Plans, Consumers Union and Blue Cross Blue Shield Association, also called for increased transparency around out-of-network care.
UnitedHealthcare is not a member of AHIP.