In yesterday’s Worcester Telegram & Gazette, there was an article (click on this link if you missed it) about UnitedHealthcare’s dispute with us over reimbursement for the services we provide to Medicare Advantage patients they cover. This is an unfortunate situation that has put our patients in the middle. As you can see from my interview with the reporter, I make the point that UHC (a multi-billion-dollar, out-of-state company) is demanding to pay us at a lower rate than our local not-for-profit insurers – all of which have agreed to fair, market competitive reimbursement rates. Our mission is to provide excellent care to all patients who come to us; however, we must be able to adequately provide that care, which is paid for through our reimbursement by the payers.

This article further illustrates the need for payment reform so that we can remain viable for the communities we serve – particularly the most vulnerable. Our responsibility as a safety net health care system is jeopardized when insurance companies like UHC do not pay us fairly for the cost of the complex care that only we provide in our region. Fair payment. That’s all we are asking for – which actually doesn’t even fully cover our costs.

We have communicated with affected patients about their open enrollment options to choose coverage by traditional Medicare or other Medicare Advantage plans accepted by our doctors and hospitals. Our frontline staff who interact with patients have received talking points to help them answer questions from UHC-covered patients. The tragic part of this situation is that it affects patients like Suzanne St. Pierre and Michael Tremblay mentioned in the article. We will continue to work with these patients to ensure they receive the care they need and deserve. And I will continue advocating and fighting for the fair treatment of our organization, so we can continue to uphold our mission and our obligation as a safety net system.

We will keep you informed if anything changes in this situation. 

Eric