Approximately 20,000 commercial and Medicare insurance policy holders with UnitedHealthcare in the Tri-Cities could lose their coverage at Wellmont Health System hospitals and associated physicians if the two companies can not reach an agreement for services by the end of the month.
An email from United's Associate Director of Communciations, Sarah Bearce, said the insurance provider is working to reach an agreement with Wellmont, but the health system is not cooperating.
"Wellmont appears to believe they should pocket higher pay without showing that they’re delivering better results for their patients," the email reads. "This is simply unfair for Tri-Cities residents. Wellmont is resisting the movement to pay-for-performance that’s underway in the broader health care system because the status quo is profitable for them. We appreciate how this can be disruptive for people, so we are committed to doing everything we can to reach an agreement that enables us to offer affordable, quality health care products to our members."
But an emailed statement from the health care system characterizes the contract renewal process differently, claiming United was the one being unreasonable during negotiations.
"Wellmont Health System is the latest
in an increasingly long line of healthcare providers that have received
unreasonable contract demands from UnitedHealthcare," spokesperson Jim Wozniak wrote. "The terms UnitedHealthcare
has proposed are unacceptable and grossly undercompensate Wellmont for the
services it expertly delivers in our region."
Stating that the system has been proactive in instating pay-for-performance models, Wozniak added that other insurance providers have been able to forge agreements for service with Wellmont.
Wozniak urged patients to seek other insurance companies for coverage and drop United.
"UnitedHealthcare has consistently shown it is
more interested in protecting its interests rather than serving its members and
physicians who provide life-saving care," he wrote.