Important information about Montefiore’s negotiation with UnitedHealthcare

UnitedHealthcare Has Dropped Montefiore From Its Network Effective January 1, 2021

The Latest:

  • In order to make progress in our negotiations, we offered United an extension based upon terms of our last contract.  
  • The extension would allow for immediate in-network access to Montefiore hospitals and physicians and last until May 31, 2021.
  • If United is ultimately unwilling to reach a new agreement by May 31, 2021, our proposed extension will honor and mimic the terms and trends over the next three years of what United provided previously in 2018.
  • Additionally, to protect you from this type of disruption again, Montefiore has asked United to remove an expiration date from this new agreement.
  • Giving your employees a path to in-network access to their doctors and hospitals is one of the most important things you as an employer can do to support a healthy work force, which drives profitability.

It’s now up to United to either provide different, sustainable terms or agree to this path forward.

At this time, we don’t know if United will join us on this path forward in a way needed to make this right for your employees.  We know most would prefer to delay care rather than search for a new doctor that fits all their needs during a pandemic. Unfortunately, absent a signed agreement with United, the only way to guarantee your employees will receive the care they prefer with Montefiore is for you to consider switching to another health plan or offering an additional health plan option.

While United refuses to work with us, both EmpireBCBS, Cigna, and Aetna have renewed their commitment to our community and Montefiore with multi-year agreements. What you can do:

  • Switch Health Plans: Select another national or local health plan to allow your employees to continue to access their trusted providers and hospitals. 
  • Offer Additional Plan (Self-Funded Employers): Offer an additional health plan option for employees which includes Montefiore in-network access with a special open enrollment retroactive to January 1, 2021. We’re honored to work with insurers like EmpireBCBS, Aetna and others who recognize the value we bring to our community and local employers. We continue to partner with major carriers including:
  • EmpireBCBS
  • Cigna
  • Aetna
  • Emblem

For a full list of plans we partner with, please visit Montefiore.org/insurance-plans-accepted.

  • Plan for the future. While we realize you may be locked-in to your current plan with United through 2021, buying season is fast approaching. Explore the many alternatives that guarantee in-network access to MHS for the full 2022 benefit year and beyond. We have long-term agreements with all other major commercial insurance plans.
  • Call United. Let them know your employees deserve better, and this has gone on long enough. Tell them that you deserve better and the product you purchased is worth less because of a diminished network.

If your employees have questions, please have them call us on our dedicated patient information line at (855) 226-3071 or visit this website.

Unfortunately, it appears United is continuing to spread misinformation to employers and brokers. Enough is enough. It’s time to finally set the record straight.

Third-Party video by Nate Kauffman. Not paid for or solicited by Montefiore. 

 

Actions Speak Louder Than Words.

  • United waited until October to respond to Montefiore’s July proposal, delaying negotiations for no clear reason. 
  • United again delayed negotiations after November 19, 2020, then in the final hours of New Year’s Eve 2020 tried to offer an extension without any good faith progress toward a deal.
  • To this day, United continues to prolong uncertainty while Montefiore continues to urge United to the table to make meaningful movement.
  • Montefiore is asking for a modest annual increase of single digits for the next 3 years, NOT 30%. Period. That’s $24M per year which equates to less than 0.01% of United’s $22.4 Billion in PROFIT in 2020.  Profits before Patients.
  • Montefiore’s ask of United would put them on par with our other payor partners.
  • United’s proposed “flat rates” at our two flagship facilities, which is 90% of our United revenue, equaling a rate reduction system wide.
  • Good faith negotiations means each party exchanges counter proposals that achieve forward progress. Communicating United’s unwillingness to consider proposals is the opposite of good faith negotiations.
  • While United continued its delays, brokers and employers received reassurance that a deal would be reached.
  • Instead of working for its consumers, United notified Montefiore at 9:00PM ET via text that it was uninterested in engaging in discussions with Montefiore; choosing to disrupt patient care.
  • United is beholden to its shareholders. Montefiore’s ONLY business is to take care of our patients – all of them.
  • Other payors recognize the work Montefiore does, and are willing to partner in meaningful ways to protect our patients, their customers.
  • Montefiore works with plenty of payors that value their care enough to keep us in network. Only United has an issue.
  • United has openly shared they are on a pursuit to strengthen their market share.
  • United has requested double digit premium hikes year after year over the last several years – well before these negotiations began.
  • Montefiore, a non-profit organization, isn’t responsible for a multi-billion-dollar corporation’s premiums – or any business decision for that matter.
  • United made $22.4B in profits in 2020 during a national pandemic. Admittedly they say those profits are national and aren’t being used in markets like New York.
  • If United had negotiated in good faith, our local employers may have had in-network access to their doctors today.
  • The United decision maker who declined Montefiore’s offer to work into the final hours to protect in-network access for New York employers and their employees, lives in Florida. She doesn’t have to experience the repercussions of United’s decisions – our local employers and communities do.
  • A recent RAND study shows that we are moderately priced compared to our peers.
  • CMS data shows that among 50 of our academic medical center peers across the country, Montefiore is the single most cost-efficient academic hospital when adjusted for cost of living and payor mix.
  • United is using rising cost scare tactics with their self-funded customers. Costs to their customers don’t automatically go up because of a single digit increase to a local non-profit health system.

How did this happen?

United decided to let Montefiore’s current contract expire as of midnight December 31, 2020. 

  • United would not consider Montefiore’s good faith proposal for months and just sat on it, which led to them dropping us from their network.
  • In the final hours of 12.31.20, without our proposal in mind, United offered an extension, without any good faith progress, that would have prolonged uncertainty until a time when you would have missed your opportunity to switch plans to one that would have restored and secured your employees’ in-network access to the Montefiore physicians and hospitals they trust.
  • Once again, Montefiore offered to negotiate in good faith to get a deal done and prevent disruption, even in the final hours. United declined our invitation.

Your employees are our patients. Their wellbeing is as important to us as it is to you. We are honored they have trusted their healthcare needs to Montefiore. It is our responsibility to ensure every partnership we enter into supports the high-quality healthcare they deserve. This is our single goal with United.

Our priority remains your employee’s health, wellbeing, and restoring their in-network access to MHS hospitals and physicians. We continue to do everything in our power to reach an agreement with United. 

What your employees should know:

  • Your employees will always have in-network access to our emergency rooms. Regardless of our contract status with United, patients experiencing a medical emergency should always visit the nearest emergency room.
  • Your employees may still have in-network access to our hospitals. Some United health insurance plans, like commercial and Oxford products, lose access to their trusted physicians effective January 1, 2021, but still have access to our hospitals through March 1, 2021. Please contact your broker or United to find out if your plan is included.

While we’re doing everything in our power to keep United focused on what’s best for your employees, our patients, the reality is the only way to guarantee your employees have in-network access to Montefiore is to switch plans.