Contract negotiations between Northwest/United Healthcare have p - Tucson News Now

Contract negotiations between Northwest/United Healthcare have patients concerned

TUCSON, AZ (Tucson News Now) -

Contract negotiations between United Healthcare and Northwest Hospital have left thousands of patients wondering about the future of their health care.
The issue is over disbursements, how much the hospital and doctors charge, and how much they get paid.
The present contract has been in force since 2004 and has been renegotiated and updated annually, however that did not happen this year.
“We were surprised,” said Kevin Stockton, the Northwest CEO. “We’ve always had a good relationship.”
In a statement issued by United Healthcare, Dave Allazetta, Chief Executive Officer, Arizona Health Plan, UnitedHealthcare, said the company “has been negotiating in good faith.”

Full statement from Dave Allazetta, Chief Executive Officer, Arizona Health Plan, UnitedHealthcare is below:   

UnitedHealthcare is honored to serve more than 2 million Arizonans and support their access to quality, affordable health care from more than 26,000 health care professionals and nearly 100 hospitals across the state. 
For the last several months, we have been negotiating in good faith with Northwest Healthcare to renew both their hospitals’ and physicians’ participation in our network for employer-sponsored, Medicare Advantage and Medicaid health plans.
Just recently, I reached out to Northwest’s local CEO in hopes of reaching an agreement quickly and amicably. Instead, our team was redirected out of state to negotiate with representatives of Northwest’s Tennessee-based parent company. After months of meetings and conversations, we remain committed to renewing Northwest’s participation in our network given their current contract expires on May 1, 2017.
UnitedHealthcare wants nothing more than to continue our relationship with Northwest. In fact, we are offering to reward Northwest for the important services it provides to our members in Southern Arizona if the healthcare system will commit to a Value-based Care model. Simply stated, value-based care means a portion of the healthcare system’s payments from UnitedHealthcare would be based on how it performs against key quality measures and improved health outcomes for its patients. 
Paying for performance has become an industry standard. More than 1,100 hospitals nationwide currently participate in a Value-based Care model with UnitedHealthcare, touching the lives of approximately 15 million patients who we collectively serve. In fact, all Arizona hospitals eligible for a Value-based Care program either participate today or are in the process of entering into a Value-based Care Model with UnitedHealthcare. Only Northwest has been unwilling to adopt this model.
Instead, the hospital system is demanding a 27 percent rate increase for employer-sponsored and individual health plans over the next three years. If we agreed to those demands, the amount local employers and employees pay for their health coverage would have to increase to cover the higher costs. For example, Northwest’s rate demands would mean an emergency room visit or outpatient surgery at a Northwest hospital would cost approximately $1,000 more. Accepting Northwest’s proposal to raise the cost of care over the next three years would have a direct financial impact on all those members who rely on us to provide affordable, quality care, as well as their employers who have committed to providing competitive medical benefits.
If we are unable to reach an agreement with Northwest Healthcare by May 1, you still have many choices for quality care throughout Tucson. UnitedHealthcare has Value-based Care contracts with Banner-UMC, Carondelet, and Tucson Medical Center; and we have more than 7,000 in-network physicians practicing throughout the Tucson metro area and surrounding counties. We urge Northwest Healthcare to join our Value-based Care program so that tens of thousands of UnitedHealthcare members in Tucson and surrounding communities can retain access to its hospitals, physicians and specialists.

Both Stockton and Allazetta say they want to find a solution and continue the relationship, but while they try to find a solution, many patients are in limbo.
One of those is Chris Clark, who was recently diagnosed with kidney cancer and needs surgery.
“If I can’t have the surgery, I’m going to die,” he said.
United Health Care said Clark may be able to apply for “continuity of care”, which means he would not be affected regardless of whether a contract is reached or not. That is not guaranteed at this point and that’s what has him concerned.
“My surgeon has ordered tests run STAT,” he said. “He wants them done right now. He wants my surgery done right now.”
But if the contract expires, his surgeon loses privileges at Northwest raising questions about a surgery that needs to be expedited. It’s the fact that so many patients are left to question their future providers that has some upset.
If the contract expires, many primary care physicians would then be classified as “out of network", which means the patients would need to find another doctor.
“There is a severe primary care shortage in Pima County,” Stockton said. “For folks to try to find a new primary care doctor quickly is very hard.”
“For many practices, the wait time can be four to six weeks, said Dr. Michael Yim, of Northwest Allied Physicians. “And some of them are closed.”
That will add to the stress many patients suffer because they lose a trusted physician of many years.
“When you spent the time getting to know a physician, you’ve built rapport, that trust, to tell them that you’ve got to take that away now, you’re going to need to go somewhere else now, that really puts the patients in the middle,” Dr. Yim said.
Michael Lokale, a D.O. in Oro Valley, says the first five or ten minutes of nearly every appointment is taken up explaining the problem and reassuring the patients that nothing has happened yet and may not.
“Some patients that have come in, that are not scheduled to come see me, they come just so they can talk to me about the United Health Care problem,” Lokale said.
United Health Care serves two million customers in Arizona and, while it’s hard to estimate, it’s thought more than 20,000 patients could be affected just in the Northwest system.
“We’re hopeful that we’ll have a contract, but in order for that to happen, the discussions have to begin very soon” Stockton said.

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