Torres and patients pressure United Healthcare against dropping health coverage and insurance

Congressman-elect Ritchie Torres spoke on Dec. 29 about pressuring United Healthcare to stay with Montefiore
Courtesy of Office of Ritchie Torres

More than 60,000 Bronx patients are at risk of losing health care insurance and access to doctors if United Healthcare does not negotiate a fair contract with Montefiore Medical Center.

On Dec. 29, Congressman-elect Ritchie Torres was joined by doctors and patients at Montefiore Urgent Care Center, 2532 Grand Concourse, as they rallied and pressured United Healthcare to keep its partnership with Montefiore.

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Montefiore Medical Center is in contract negotiations with United Healthcare concerning health coverage and premium payments, yet United Healthcare refuses to come to the negotiation table in good faith and is putting patients at risk of losing  coverage. In the first three quarters of 2020, when the pandemic was ravaging the Bronx, United Healthcare made over $15 billion in profits and yet it is unclear if those profits are being used to improve patient healthcare.

Without a new agreement its contract expired at midnight on Dec. 31.

“Montefiore is grateful to Congressman-Elect Torres and other community leaders for taking a stand on this urgent issue,” said a Montefiore spokesman. “Come Jan. 1, United will block 60,000 Montefiore patients from seeing their trusted Montefiore doctors at in-network rates because United has refused to negotiate in good faith. Montefiore remains focused on our patients, our community and on avoiding any disruption of care.”

Montefiore is only asking for rates that will put United on the same level as other insurance payors. It serves a population made up of over 85% of patients covered by Medicare or Medicaid. With these numbers continuing to increase because of the pandemic, the hospital doesn’t have the resources to cover $300 million plus in incremental pandemic related costs while payors or United profit.

In December, Community Board 5 sent a letter to Michael McGuire, CEO of United Healthcare pleading with them to renew its contract with Montefiore and asking that Monefiore Heath System reimbursement rates not be reduced.

“Any potential in reduction in access to health benefits because of a decrease in your plan’s reimbursement rate is unconscionable,” said Community Board 5 Chairman Dr. Bola Omotosho. “The nation is in a pandemic. Access to good quality and affordable health care is absolutely vital. Bronx Community Board 5 depends on the Montefiore health system to a very large extent for its health care needs.”

Before COVID-19 Community Board 5 had a poverty rate of 35%, 16% of adults have diabetes, childhood obesity sits at 24% and the child hospitalization rate was 1,297 per 100,000 kids 4 years old or younger.

McGuire replied to Community Board 5’s letter.  He explained that his company wants to work with Montefiore to keep the partnership going, but things are becoming quite difficult.

He noted that Montefiore has refused to engage in meaningful negotiations and continues to demand price hikes of nearly 30% over the next three years, which would drive up health care costs by $216 million for New York employers and families.

Additionally, not only is Montefiore the most expensive health system in New York City, but the rates United Health reimburse its hospitals at its Moses and Einstein campuses are also higher than any other hospital in the state.

McGuire also pointed out that a substantial portion of the patients Montefiore are enrolled in Medicaid. In recognition of this, United reimburse its physicians at rates that are significantly higher than the rate it pays other providers in the market when they care for Medicaid members.

“Throughout our negotiation we’ve worked to find a middle ground that balances Montefiore’s rate demands with the economic needs of the employer group customers and members we serve,” McGuire said in the letter. “We recognize that hospitals and doctors in New York City have been some of the hardest hit by the COVID-19 pandemic. That is why we have never asked Montefiore to accept rate decreases.

In fact, our last proposal would raise the reimbursement rates we pay most of Montefiore’s hospitals, despite its position as the most expensive health system in New York City. This proposal demonstrates our willingness to compromise as part of good-faith negotiations designed to get a deal done.”

 

 

 

 

 

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