WakeMed and insurer UnitedHealthcare reach a deal after months of failed negotiations
WakeMed and UnitedHealthcare signed a new three-year contract after months of failed negotiations that affected thousands of patients, the health system and the insurer announced Thursday.
The two companies had been without a contract for more than four months, making WakeMed hospitals, outpatient clinics and physician specialists out-of-network for UnitedHealthcare members.
WakeMed will immediately resume in-network scheduling and services to UnitedHealthcare members, the health system said in a letter to patients.
The contract does not include United’s Medicaid Managed Care plan, the Medicare Select plan, or UnitedHealthcare plans available on the health care marketplace/exchange.
“We know the past few months have been incredibly challenging for you — our valued patients,” WakeMed said in the letter. “We are confident that the contract signed this week will protect the patient-provider relationship.”
Asked to provide more details, WakeMed declined, saying only, “Both parties came to an agreement on reasonable language and reimbursement terms.”
How insurance dispute began
The dispute began about a year ago when WakeMed told UnitedHealthcare that it wanted a new contract to replace one that expired in the summer of 2022.
During months of negotiations, the companies butted heads over reimbursement policies, rate increases and insurance claim errors. They failed to come to an agreement, and their contract lapsed on June 1, 2022.
UnitedHealthcare argued that the talks broke down when WakeMed asked for a 20% rate increase, which the company said would drive up insurance premiums.
WakeMed claimed the disagreements centered around declined reimbursements, which it said were five times higher than other large insurers, such as Aetna and Blue Cross and Blue Shield.
Those disagreements are now behind the two parties, at least for the next three years.
“We recognize the care WakeMed provides is important,” Garland Scott, CEO of UnitedHealthcare North Carolina, said in a statement. “We’re pleased to reach an agreement that provides the North Carolinians we serve greater access to quality, affordable health care.”
Teddy Rosenbluth covers science and healthcare for The News & Observer in a position funded by Duke Health and the Burroughs Wellcome Fund. The N&O maintains full editorial control of the work.
