Contract negotiations between Saint Francis Healthcare System and UnitedHealthcare have effects that will ripple throughout Southeast Missouri.
United customers would see many Saint Francis facilities leave the insurer’s network March 5 unless the two can agree to terms on a new contract that would impact the health care system’s pricing. United terminated its contract with Saint Francis in November while negotiation continues. With the end date approaching and negotiations stalled, Saint Francis officials announced the termination Monday, contending United wants the system to accept payment cuts of 20% to 30%, which would be “radical” and “unsustainable.”
United countered that Saint Francis rates are too high and it is willing to walk away from the network if necessary.
“If we are unable to reach an agreement, Saint Francis Medical Center, as well as ancillary providers tied to the hospital agreement, will be out of network for employer-sponsored, individual and Medicaid members, effective March 5,” a statement from United stated. “Saint Francis does not currently participate in the network for UnitedHealthcare’s Medicare Advantage members.”
The statement also said Saint Francis’ rural health clinics would be out-of-network “for Medicaid members only, effective March 5.” The statement said those clinics are not in-network for employer-sponsored and individual plans.
Area facilities that would leave the United network, at least for some customers, according to United include:
• Saint Francis Health Delivery Home Health
• Saint Francis Hospice
• Saint Francis Rural Health Clinics
• Immediate Convenient Care
• Kniebert Clinic
• Charleston Family Care
• Jackson Family Care
• Jackson Physician Associates
• Saint Francis Outpatient Clinic
• Physician’s Park Primary Care
• Piedmont Physician Associates
• Ferguson Medical Group locations in Sikeston, Charleston, East Prairie, Dexter and Scott City
• Poplar Bluff Pediatrics
Saint Francis officials said patients should contact the health care system directly to determine eligibility.
“The list that UnitedHealthcare publicly provided is not necessarily accurate,” an emailed statement said. “We encourage patients to call the patient information line at (573) 331-5217 for specific information regarding their plan design.
Physicians affiliated with Saint Francis are not affected by the contract impasse. Doctors contract with United separately. That contract is up for renewal at the end of June.
Patients receiving long-term care — such as expectant mothers and those undergoing cancer treatment — who want to continue to use Saint Francis facilities with in-network pricing would have to receive permission from United to do so.
Saint Francis developed a website, www.keepusin.com, and the information line, to answer patient questions. The website directs patients who have employer-sponsored insurance plans with United and who have questions about whether their particular facility will remain in-network to contact their employer’s human resources department.
United recommended its customers call the telephone number listed on their insurance card if they have questions about their coverage.
This disagreement affects only United customers with an individual or family plan and certain Saint Francis facilities.