The University of North Carolina (UNC) Health is planning to end its contract with UnitedHealth because it is “not negotiating with us in good faith.” Two hundred thousand people enrolled in UnitedHealth’s North Carolina plans are likely to lose their access to UNC Health, reports MedPage Today. As more and more hospital systems throughout the country face health insurer prior authorization delays and denials, denials of payments and other financial and administrative burdens, people are at serious risk of care disruptions.
If UnitedHealth doesn’t meet UNC’s needs, tens of thousands of people in UnitedHealth’s Medicare Advantage plan in North Carolina will lose access to UNC hospitals and providers effective April 1, 2024. They are not alone. Equally concerning is that many smaller and rural hospitals are closing as a result of UnitedHealth and other health insurers failing to pay them appropriately.
UNC Health’s chief clinical officer Matthew G. Ewend, MD says that UNC needs to hold UnitedHealth accountable for underpayments and undermining patient care. UnitedHealth is not prioritizing patient health and well-being. He says, “UnitedHealthcare improperly denies claims and causes unnecessary delays in patient care. This can negatively affect your well-being.”
Since now is open enrollment season, UNC is urging its patients to find a new insurer rather than face disruptions in care in 2024. John Buse, MD, director of the UNC Diabetes Care Center, said “We need a single-payer healthcare system! The incentives are all wrong.” He is so right.
So long as insurers profit from delays and denials of care and coverage, they will continue to delay and deny care and coverage inappropriately. Unfortunately, it seems that neither the states nor the federal government have the will or the power to hold them accountable for their bad acts. A review of enforcement actions by the Centers for Medicare and Medicaid Services against Medicare Advantage plans in 2023 reveals not a single enforcement action.
Here’s more from Just Care:
- Insurers will continue misleading people, notwithstanding new Medicare Advantage marketing rules
- If you’re in a Medicare Advantage plan, watch out! Your doctor or hospital might no longer be in-network
- Medicare Advantage endangers rural hospitals
- OIG finds widespread inappropriate care denials in Medicare Advantage
- If you want easy health care access and good quality care, you probably want traditional Medicare
I have been happy with United Health as a Supplemental to original Medicare for over12 years, and after 1year with them for Medicare Part D. But Medicare Advantage–never! Not with United or anyone else.