Duke Health is notifying patients that their coverage could be impacted by a contract dispute with UnitedHealthcare, one of the U.S.’s largest insurers.
Why it matters: If a deal isn’t reached by Oct. 31, Duke Health patients with UnitedHealthcare insurance will be considered out of network, meaning most will need to pay more out of pocket or find a new doctor or health system, Duke informed patients in a Monday letter obtained by Axios.
- Around 170,000 Duke Health patients throughout the state could be affected if the UnitedHealthcare contract expires, per Duke Health.
The big picture: This isn’t the first time a health system in the Triangle has gone public with its contract negotiations with UnitedHealthcare.
- Last year, UNC Health warned patients of potential disruption due to contract negotiations with the insurer but ultimately came to an agreement four days before its contract expired.
- In 2022, WakeMed saw thousands of UnitedHealthcare patients go out of network for months before it signed a new contract.
Zoom in: Duke and UnitedHealthcare have been negotiating since April, according to a UnitedHealthcare spokesperson, and the insurance company sent its fourth proposal to Duke on Tuesday.
What they’re saying: Duke Health said in a statement to Axios that it hopes UnitedHealthcare will agree to a new contract that fairly reimburses Duke.
- In its letter, Duke Health said UnitedHealthcare’s reimbursements have not kept up with inflation.
- “To continue serving the patients and families who trust us for unmatched quality, expertise and the best possible outcomes, we must ensure that UnitedHealthcare — and all insurance companies we partner with — reimburse Duke Health at fair rates that cover the rising cost of care,” the health system said in the statement. “That is why we are negotiating today.”
The other side: The UnitedHealthcare spokesperson said its priority is reaching an agreement with Duke Health.
- “We delivered a new proposal on Aug. 20 that includes meaningful rate increases that would ensure Duke continues to be reimbursed similar to peer health systems,” UnitedHealthcare spokesperson Cole Manbeck said in a statement.
- “We will remain at the negotiating table as long as it takes to reach an agreement,” Manbeck added. “We hope Duke joins us there and works toward a solution that North Carolina families and employers can afford.”
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My name is Gwendolyn Hairston and I have UHC and I have a very serious eye issue what do I do if the contract is not renewed, will I have the necessary time to switch to insure I have coverage. Please advise.
I was told by Duke receptionist on oct 30 2024 when making an appt that contract with Duke and UHC ends nov 1. In a couple days. I called UHC and they said there is not a contract end date with Duke. Duke says UHC will be out of network starting nov 1 2024
I would never have expected United Health Care to become a huge bully that uses patient welfare as a negotiating tactic. It is a gross failure of their responsibility to patients. Perhaps it is time for government regulation to prevent this behavior by a health service organization. DukeHealth shares some responsibility but only United Health Care seeks to intimidate Duke and its huge number of patients with threats to withdraw health care benefits.