Local

Piedmont, UnitedHealthcare Miss Deadline For New Contract

July 1st, 2016

More than 100,000 people who get their health insurance through UnitedHealthcare will likely have to pay more to get care at most Piedmont facilities starting Friday, after the two deadlocked on a new network agreement.

United and Piedmont had until Thursday to reach a new agreement before the current three-year plan expired. After months of negotiation, the two couldn’t work out a plan before the deadline.

With no deal, five Piedmont hospitals and hundreds of the system’s physicians are now considered out of network for an estimated 150,000 metro Atlanta residents with United’s commercial plans. One hospital, Piedmont Newton, is not included in the dispute and remains in United’s network.

“Our goal certainly remains to find a solution that would renew in-network access to both the physicians and hospitals at Piedmont, and to do so while providing them the fair and competitive rate increases that they deserve,” said United spokesman Daryl Richard.

Richard blamed Piedmont for the now-lapsed contract, citing what he said were requests from the hospital network to raise the cost of care by 30 percent over the next three years.

Piedmont declined a request for an interview, but issued a statement.

“Piedmont has always been focused on reducing the cost of care. It is well known inside the industry that Piedmont’s costs are comparable and in many cases lower than other systems in Atlanta. For the sake of our patients, we will continue to work with United to reach an agreement that allows Piedmont to best serve the communities we call home. We urge United to engage in good-faith negotiations with us to reach a fair and equitable agreement that allows members of our community in-network access to Piedmont facilities and Piedmont Clinic physicians that they know and trust.”

Professor David Howard of Emory University’s Rollins School of Public Health said the two have a big incentive to strike a deal at some point.

“Piedmont is going to miss out on all of United customers, which is a significant share of the market. They’re going to go to other hospitals, and Piedmont is going to lose out on that revenue,” Howard said. “And from United’s perspective, if they don’t have Piedmont in the network, they will find that people drop their health plan, and insurers may be reluctant to renew their contracts.”

The city of Stockbridge has already announced plans to drop United and switch its city employees to Cigna.

Patients can still go to Piedmont facilities and doctors, but they’ll likely have to pay more out of pocket to do so because they’re no longer in their insurance coverage network.

Both Piedmont and United say they’ll continue talks in hopes of eventually reaching a deal.