Insurer Refuses to Keep Envision Clinicians in Their Network

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12.31.2020 -

 

UnitedHealthcare Cuts Clinician Pay and Patient Benefits During COVID-19 Pandemic

 

 

NASHVILLE, Tenn. — UnitedHealthcare has decided not to renew its longstanding partnership with Envision Healthcare in the midst of a national health crisis. This means Envision’s clinicians will not be part of United’s insurance plans starting January 1, 2021.

 

United’s decision comes at a time when Envision’s 25,000 clinicians have cared for approximately one out of every 10 hospitalized COVID-19 patients.[1] Although Envision does not balance bill patients,[2] it cannot prevent patients from receiving higher surprise bills from United, including bills related to COVID-19 care. While United waives patient cost sharing for in-network COVID-19-related care, United’s cost-sharing waiver does not apply to all out-of-network in-patient COVID-19 costs[3]. United’s COVID-19 coverage means that one in 10 patients who go to an emergency room may face a surprise gap in coverage.

 

In addition to reducing coverage for patients, United keeps reducing reimbursement for doctors while reporting record profits, including more than $6 billion in the second quarter of 2020.[4]

 

Following lengthy negotiations in 2018 in which United claimed Envision’s rates were two times their median[5], Envision took significant rate reductions. Two years later, in the midst of a national health crisis and record profits, United is claiming that Envision’s rates are now three times their median[6], a multiple only possible if United has cut reimbursement rates for emergency room doctors in the country by 50 percent. While Envision has offered to meet United more than halfway in an effort to stay in-network during this national health crisis, Envision believes the immediate and drastic cuts to clinician pay that United is demanding at this time would be irresponsible.

 

“Our health care workers risk their lives every day taking care of patients who are fighting for theirs. In the middle of all this, we have United, an insurance and financial services company, that will only keep us in their network if we cut our doctors’ pay. This is wrong. I don’t know what to conclude except United does not value doctors or patients,” said Doug Smith, MD, FACEP, President of Envision Physician Services. “We’re going to keep taking care of patients and treating them right, regardless of what any insurance company does.”

 

 

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About Envision Healthcare Corporation
Envision Healthcare Corporation is a leading national medical group that delivers physician and advanced practice provider services, primarily in the areas of emergency and hospitalist medicine, anesthesiology, radiology/teleradiology, and neonatology to more than 1,800 clinical departments in healthcare facilities in 45 states and the District of Columbia. Post-acute care is delivered through an array of clinical professionals and integrated technologies which, when combined, contribute to efficient and effective population health management strategies. As a leader in ambulatory surgical care, the medical group owns and operates 255 surgery centers in 34 states and the District of Columbia, with medical specialties ranging from gastroenterology to ophthalmology and orthopedics. In total, the medical group offers a differentiated suite of clinical solutions on a national scale with a local understanding of our communities, creating value for health systems, payers, providers, and patients. For additional information, visit www.envisionhealth.com.

 

[1] Envision Healthcare Continues Supporting Patients and Clinicians, Meeting COVID-19 Care Demand: https://www.evhc.net/news-resources/in-the-news/2020/envision-healthcare-continues-supporting-patients-and-clinicians

[2] https://www.envisionphysicianservices.com/billing/covid-19-billing-faq

[3] https://www.uhcprovider.com/en/resource-library/news/Novel-Coronavirus-COVID-19/covid19-testing/covid19-treatment-guidance.html

[4] UnitedHealth posts most profitable quarter in its history: https://www.axios.com/unitedhealth-coronavirus-second-quarter-profits-0ff4a160-6e50-4b77-84d9-9a2bff9358d7.html%202

[5] https://www.fiercehealthcare.com/payer/envision-doubles-down-marketing-push-to-get-back-unitedhealth-s-network

[6] Letter from Angie Nierman, Vice President of Network Contracting at UnitedHealthcare to Facilities

 

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