UnitedHealthcare, Trinity resolve network dispute – Healthcare Finance News

 
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UnitedHealthcare and Trinity Health of New England have settled a public dispute by agreeing to a new, multi-year contract for the health system’s hospitals, facilities and its physicians that’s retroactive to July 1.
In a statement, UHC said the new relationship provides network access to all of the health system’s hospitals, facilities and its physicians for people enrolled in UHC employer-sponsored commercial plans and Medicare Advantage plans, including Group Retiree and Senior Care Options (SCO).
The agreement also provides network access to all of Trinity’s providers throughout Connecticut for UHC’s Dual Special Needs Plan (DSNP), while people enrolled in the One Care (MME) plan have network access to St. Francis Hospital and Mercy Medical Center.
“We thank our members and customers for their support and patience throughout this process,” UHC said in a statement. “We are honored to continue supporting all of the people throughout Connecticut and Massachusetts who depend on us for access to quality and affordable healthcare.”
WHAT’S THE IMPACT
The action reverses a July 17 decision that Trinity would no longer accept UHC insurance at any of its practices and facilities due to a dispute over reimbursement rates.
“Our goal always is to avoid disruptions for patients,” said Montez Carter, PharmD, FACHE, president and CEO at Trinity Health Of New England. “This agreement was necessary to ensure Trinity Health Of New England can continue delivering the high-quality affordable care people need. With fair reimbursement, we can continue to invest in our colleagues, medical staff, innovative treatments and important health programs, protecting access to care now and in the future.”
Claims submitted since the beginning of July will now be considered in-network, which the health system and insurer said should mitigate potential patient disruptions.
THE LARGER TREND
UHC parent company UnitedHealth Group (UHG) rebounded from a challenging first quarter to post a $4.2 billion profit in Q2, logging revenues of $98.9 billion.
That’s quite a turnaround from Q1, during which the insurer reported a $1.4 billion loss. That was largely due to the massive cyberattack on Change Healthcare, as well as a divestiture of its Brazilian business, which was completed in the first quarter.
Optum was the biggest driver of UHG’s revenue growth in the quarter, posting $62.9 billion in revenue, an increase from the $56.3 billion logged in Q2 2023. Revenues at Optum Health and Optum Rx, the company’s pharmacy benefit manager, were both up 13%.
Jeff Lagasse is editor of Healthcare Finance News.
Email: jlagasse@himss.org
Healthcare Finance News is a HIMSS Media publication.


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