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Mount Sinai Health System and UnitedHealthcare (UHC) leaders traded barbs Tuesday amid contract negotiations over in-network access.
The New York-based health system urged the insurer to continue UHC/Oxford Health Plan’s in-network access at Sinai hospitals and outpatient locations, warning that a lapse in access would hurt patients who rely on those facilities.
UHC removed some Mount Sinai hospitals and outpatient settings (Mount Sinai Beth Israel, Mount Sinai Brooklyn, Mount Sinai Morningside, Mount Sinai South Nassau, Mount Sinai West, and New York Eye and Ear Infirmary of Mount Sinai) from its network as of January 1, the health system noted.
UHC officials attributed the move, which affects patients with either employer-sponsored or individual commercial plans as well as plans including Oxford, to the health system’s “refusal to move off its demands for a near 50% price hike over the next three years” that would increase healthcare costs by an estimated $600+ million.
“We remain committed to continued discussions with Mount Sinai should the health system provide a realistic proposal New Yorkers and employers can afford,” UHC said in a statement. “However, our top priority at this time is ensuring the people we serve have access to the care they need through either continuity of care or a smooth transition to a new hospital.”
Network access to all Mount Sinai hospitals will continue for patients enrolled in fully insured UHC commercial plans through at least the end of February, according to UHC. Meanwhile, self-insured commercial plan enrollees will only have access to Mount Sinai Hospital and Mount Sinai Hospital of Queens during that same period.
The insurer noted that Mount Sinai physicians should not be affected by the negotiation.
Still, health system leaders said they remain “committed to working with UHC/Oxford to find a mutually agreeable solution” that ensures Mount Sinai hospitals, doctors, nurses and other providers are “paid fairly.”
“UHC/Oxford on average pay Mount Sinai 30% less than our peer facilities in New York for the exact same care and up to 50% less for many procedures,” the leaders said in a statement. “As Mount Sinai costs substantially less than our peers, UHC/Oxford will actually end up paying more for patients to get care at other systems in New York. This cost—estimated to be at least $140 million more over the course of a year—will be passed on to employers and patients.”