BRISTOL, Conn. — Effective Nov. 18, 2013, Bristol Hospital and Health Care Group Inc, will potentially no longer participate with United Healthcare, which includes Oxford Health Plans. This will impact both United Healthcare’s commercial and Medicare Advantage business. Bristol Hospital moved forward with this termination after several months of extensive negotiations, stating that United’s health plan doesn’t provide adequate reimbursement for treatment by its physicians and the Hospital.
“This was a very difficult decision for us but our mission is caring for our patients,” said George Eighmy, CPA, FHFMA, vice president of finance and chief financial officer of Bristol Hospital and Health Care Group.
“We understand and recognize that as part of fulfilling this mission we need to participate with health insurance companies providing coverage throughout the communities we serve. But after months of negotiating with United Healthcare, we were unable to reach a fair and equitable agreement. The rates that were proposed by the Bristol Hospital were consistent with those paid by other health plans.”
Eighmy added that the reimbursement rates offered by United were too far below what the hospital requires to achieve its mission to provide high quality health care services. Bristol Hospital provides care regardless of a patient’s ability to pay and it absorbs a high amount of costs for charity care provided. Last year Bristol Hospital provided more than $5 million in charity and free care.
During the notice period and even after the final termination date, emergency care at Bristol Hospital will continue to be covered under the terms of United’s member agreements. In the event of termination, United Healthcare members and physicians can also request out-of-plan referrals for Bristol Hospital. If an out-of-plan referral is approved, United Healthcare will be responsible for the payment. Additionally, those United Healthcare members with out-of-network benefits or who have access to the MultiPlan network can continue to access the hospital as a covered patient.
“We recognize that this may create a potential disruption for our patients who want access to our services,” Eighmy said. “Our goal is to help affected employers make alternative arrangements for a health plan that includes Bristol Hospital and our physicians that they would like in their network.”
Bristol Hospital maintains contracts with the other major health plans in the area including Aetna, Anthem, CIGNA, and ConnectiCare.
Bristol Hospital will continue to use all reasonable efforts to negotiate an agreement with United, even after the termination date. The community is encouraged to contact United Healthcare and stress the importance of keeping Bristol Hospital in its network by 877-842-3210.