OKLAHOMA CITY (KFOR) – Negotiations for more funding are still underway between OU Health and United Healthcare, but an agreement did not meet United Healthcare’s deadline of May 1 which now denies those patients from being treated at OU Health.
According to a United Healthcare spokesperson, OU Health sent a notice in October of 2021, terminating their contract at its conclusion along with a request for rate increases.
The first notice alerting UHC insurance holder was sent in March followed by another in April.
Dr. Robert Mannel, M.D., the Director of OU Health Stephenson Center told KFOR the university requested “modest rate hikes” to combat inflation and the effects of covid-19. “Even with those modest hikes we would not break even compared to previous years because of the increase in costs of staff.”
OU Health initially demanded a 40% rate increase over three years, which would have raised health care costs for Oklahomans by $49 million.
That request was denied by United Healthcare.
Since then, OU Health has made at least five counter proposals by lowering their asking rates, according to Dr. Mannel.
The latest request is a one-year deal that would make the hospital 34% more expensive than other Oklahoma City hospitals.
“This is not affordable or sustainable for Oklahomans,” added Spencer Leuning, a UHC spokesperson.
UHC released a statement on their website about the ongoing negotiation with OU Health in which it states,
“Throughout the negotiation, OU Health’s demands would have increased premiums and out-of-pocket costs for our members as well as the cost of doing business for companies that simply want to offer affordable health care coverage for their employees.”
The statement also said OU’s current proposal would directly drive-up health care costs for self-insured customers, given that those employees pay the cost of their employees’ medical bulls themselves rather than relying on UHC to pay those claims. In Okla., 71% of UHC members are enrolled in self-insured plans.
OU Health combats that statement by saying they are asking for a contract that keeps pace with the increasing needs of their patients.
April Sandefer, the Director of Communications for OU Health said UHC is asking OU Health to take a 39% rate cut for their physicians and a 20% cut for their facilities. “A decrease of this kind is simply not sustainable to our mission and is unacceptable to our physicians, nurses and the care of our patients.”
OU Health claimed UHC is not responding to their requests to discuss the continuity of care for their patients. OU also claims UHC has been unresponsive to allowing OU back into their network.
However, UHC is urging OU Health to accept their latest proposal to restore network access for those patients.
As negotiations continue, patients like Kelley Beard are struggling to find a new doctor.
Beard has had surgery on her back twice, one in November of 2021 and another in May of 2022. She is to have two more post-ops this year to ensure her back is completely fused together, but because United Healthcare is no longer in network, she cannot set up her final appointment.
Beard told KFOR it’s disheartening to hear what’s going on between OU Health and United Healthcare as she is hearing other patient’s medical stories and how they can no longer be treated.
Beard is currently doing her homework on other physicians in the area in hopes of finding another to take over her care. She has two in mind but hasn’t settled on one yet.
Another OU patient, Andrew Heyn is having the same struggle in trying to find someone, but he would prefer the same doctor handle his records rather than starting all over with someone new.
“I was kinda take back by it. You pay for your health insurance, and you don’t expect to be told hey we’re not going to honor this anymore,” said Heyn.
Heyn is in communication with United Healthcare looking to evaluate his options. Looking back on his experience with OU Health, he said he feels like “just another number” and not a “cared for patient.”
In the meantime, Dr. Mannel said OU Health is offering continuity of care for three months to all United Healthcare patients, but that will only include office visits.
Thousands of United Healthcare patients can no longer be seen at OU Health