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Regional hospitals reach agreement with UnitedHealthCare

After a four-month lapse, services from physicians working for hospitals in Clyde, Sylva and Bryson City will be back in-network with UnitedHealthCare as of May 1. These services had been out-of-network since the previous contract lapsed Jan. 1.

In addition to putting physician services back in-network, the agreement also includes a multi-year contract for the hospitals themselves, said UnitedHealthCare spokesman Cole Manbeck. The existing contract between Harris Regional Hospital, Haywood Regional Medical Center and Swain Community Hospital was set to expire later this year. 

“This is a win for our patients who deserve access to quality care here at home, and we appreciate your patience as we worked through this process … From the outset we have been committed to ensuring your healthcare needs would continue to be met, and we are pleased to continue this commitment,” reads a statement from the hospitals. “Our new contract gives us the ability to continue reinvesting in patient care by recruiting new physicians and caregivers and enhancing the services we provide.”

The disagreement between United and the hospitals had hinged on reimbursement rates for physicians employed by the hospitals. In a statement released in October 2018, the hospitals said that United was reimbursing physicians at rates “significantly below market average” and that the arrangement was “simply unsustainable long-term.”

Meanwhile, Manbeck said at the time that Duke LifePoint, which owns the hospitals, had been stalling the negotiating process, “failing to provide us a single proposal or inform us what they are seeking in this negotiation.”

In an email sent April 16, Manbeck said that United has reached multi-year agreements with Duke LifePoint for seven North Carolina hospitals, including Harris, Haywood and Swain. 

The contract is private, so it is unknown how many years the agreement covers or whether the hospitals got the higher reimbursement rates they wanted. 

Reimbursement rates had also been the issue in a 2017 contract lapse between Blue Cross Blue Shield and Mission Hospital. Mission announced in July 2017 that it would not be renewing its contract with BCBS and went out-of-network Oct. 5, remaining so until more than two months later, Dec. 15. HCA Healthcare purchased Mission for $1.5 billion on Feb. 1. 

In November 2018, LifePoint Health and RCCH HealthCare Partners merged and are now operating as one company under the LifePoint name. 

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