WakeMed announced on Tuesday that UnitedHealthcare will no longer cover Medicare Advantage plans starting Saturday, Nov. 15th, unless a deal is reached.
The two organizations are in the middle of negotiations, both with the contracts set to expire on Saturday.
Officials with UnitedHealthcare told WRAL News they are focused on reaching an agreement that is affordable for people and employers.
“WakeMed is demanding a near 40% price hike, including a 30% rate increase in just the first year of our contract that would make it the most expensive health system in the Raleigh market. WakeMed’s proposal would increase health care costs for North Carolinians and employers by more than $94 million over two years,” the statement read in part.
UnitedHealthcare officials said they are proposing a “meaningful rate increases that continue to reimburse WakeMed at market-competitive rate.”
Officials with WakeMed told WRAL News they are working diligently to negotiate with UnitedHealthcare, with the “intent of staying in-network,” and said officials have “walked away from discussions related to their Medicare Advantage plans.”
“On November 7, UHC notified WakeMed that they would no longer participate in negotiations related to their Medicare Advantage plans. As a result, we expect that WakeMed hospitals, outpatient clinics, urgent cares and physician specialists will be out of network for UnitedHealthcare Medicare Advantage plans beginning November 15, 2025,” WakeMed officials said in part.
Officials said they “remain at the table in good faith with the hope that UHC will join us to come to a fair agreement with a shared commitment to patients.”
“We cannot accept the terms UHC has proposed to date, as they put WakeMed at risk for being able to take care of our community and deliver on our mission of caring for all. With the rising supply, equipment, and labor costs, UHC’s proposal with no reimbursement increase to keep pace with inflation for the next four years is not only unacceptable but impossible,” the statement continued.
WakeMed officials said rates paid by UnitedHealthcare are “far below” those paid to other Triangle hospitals for the same services.
“This disadvantages WakeMed in many ways when trying to compete to hire nurses, physicians and paying competitive benefits, and limits our business development initiatives.”
UnitedHealthcare Officials also said if an agreement is not reached by Saturday, WakeMed’s facilities and specialty providers will be out of network for employer-sponsored and individual commercial plans, as well as Medicare Advantage plans.