Lehigh Valley Health Network said Monday it is planning to drop UnitedHealthcare insurance plans, a move that could lead to higher out-of-pocket costs for approximately 70,000 patients starting next year.<\/p>\n
LVHN, part of Jefferson Health, said it had been negotiating with UnitedHealthcare on new contract terms for more than two years, but those efforts have failed. It sent a letter to UnitedHealthcare on Monday.<\/p>\n
\u201cLike all health systems, we are facing significant headwinds as costs rise faster than reimbursement,\u201d Mark Whalen, executive vice president and enterprise chief strategy and transformation officer for Jefferson Health, said in a statement. \u201cSustainable, fair payment is essential to maintaining access and quality for the communities we serve. When reimbursement falls substantially below negotiated levels, it threatens our ability to fulfill our mission of providing exceptional care to all patients.<\/p>\n
\u201cOur goal remains to reach a fair agreement with UnitedHealthcare that ensures fair reimbursement so that we can protect access to essential health services for patients.\u201d<\/p>\n
If new agreements aren\u2019t reached, contracts will end Jan. 25, 2026, for patients who have Medicare Advantage plans through UnitedHealthcare, and April 25, 2026, for patients with commercial insurance policies.<\/p>\n
The Morning Call has reached out to UnitedHealthcare, one of the country\u2019s largest insurers, for comment.<\/p>\n
The move only affects patients seeking care at legacy LVHN hospitals and doctor offices. Jefferson Health has separate contracts with UnitedHealthcare that will remain in effect.<\/p>\n
This is not the first time LVHN has moved to terminate contracts with an insurance company over what it says are unfair and inadequate reimbursements.<\/p>\n
In November 2022, LVHN threatened to stop accepting Aetna plans<\/a> for what it said was refusal to pay for health care provided to members and denying or delaying care. However, the health network and insurer reached a new agreement about a week later<\/a>.<\/p>\n Terminating its contract does not mean UnitedHealthcare patients must stop seeing their LVHN doctors. However, it would mean they face higher costs, as providers would be considered out of network.<\/p>\n LVHN advises patients keep their current appointments, as coverage remains in effect.<\/p>\n This is a developing story. Check back for updates.<\/p>\n","protected":false},"excerpt":{"rendered":"Lehigh Valley Health Network said Monday it is planning to drop UnitedHealthcare insurance plans, a move that could…\n","protected":false},"author":2,"featured_media":100835,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[34],"tags":[66700,114,66701,163,521,85,46,38486,66702,224,38487,66703,38104,43,11662,11663,66704,66699],"class_list":{"0":"post-100834","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-healthcare","8":"tag-berks-county","9":"tag-business","10":"tag-carbon-county","11":"tag-health","12":"tag-healthcare","13":"tag-il","14":"tag-israel","15":"tag-lackawanna-county","16":"tag-lehigh-county","17":"tag-local-news","18":"tag-luzerne-county","19":"tag-monroe-county","20":"tag-montgomery-county","21":"tag-news","22":"tag-northampton-county","23":"tag-pennsylvania","24":"tag-schuylkill-county","25":"tag-top-stories-tmc"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts\/100834","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/comments?post=100834"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/posts\/100834\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/media\/100835"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/media?parent=100834"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/categories?post=100834"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/il\/wp-json\/wp\/v2\/tags?post=100834"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}