CINCINNATI — After more than a year of negotiations, TriHealth and UnitedHealthcare still haven't reached an agreement that would keep the health care provider in the insurance company's network beyond Dec. 31.
TriHealth is now warning patients that UnitedHealthcare is expected to be out of network after the New Year, a change that could send health care costs skyrocketing for thousands of Tri-State residents.
WATCH: Learn more about TriHealth and UnitedHealthcare's negotiations
Patients caught in the middle
With the deadline just days away, patients are growing increasingly concerned about potential disruptions to their care and rising out-of-pocket costs.
"Well, first of all, my gut feels sick. It makes me feel afraid. Being one of the people who's living on a fixed income right now on social security, you know, it's going to be very problematic if I have to pay more for my health care. We're already paying so much more for so many things," Deborah Kovacs-Sturdevant said.
Kovacs-Sturdevant is among many patients worried about the potential impact on their health care access and costs.
"And it infuriates me because I feel like, like the subscribers, UnitedHealthcare subscribers are being used as pawns in this," she said.
Warning messages sent to patients
Those frustrations are being fueled by messages patients are receiving, including calls and texts warning that TriHealth expects UnitedHealthcare to be out of network after Dec. 31.
Dr. Raymond Metzger, president of TriHealth, said the health care system doesn't want patients caught in the middle of the dispute.
"Their actions over the course of our discussions have consistently jeopardized their members' access to TriHealth. We do not want our patients to be caught in the middle," Metzger said.
Potential widespread impact
Patients like Kovacs-Sturdevant say they're already caught between the two health care companies, with potential impacts across the Tri-State region.
"It's going to create an immediate problem in the industry locally, because I'm not going to be the only one who's going to look to jump ship. Everybody is. And, you know, physicians can only take a certain amount of patients, especially new patients," she said.
If you have any questions about TriHealth and UnitedHealthcare's dispute, consumer reporter Taylor Nimmo would like to hear them. You can contact her below:
Both sides blame each other
TriHealth says they're still hopeful for an agreement but are warning patients now so they can plan ahead.
"We've tried to make sure patients who need ongoing treatment can continue to visit our hospitals, clinics and doctors without interruption. But UnitedHealthcare refused to help us pre-qualify these patients," Metzger said.
UnitedHealthcare denies TriHealth's claims, stating that it has approved all continuity of care requests received to date.
A spokesperson with UnitedHealthcare said: "TriHealth continues to demand significant price hikes—the majority of which would come out of the budgets of local employers—impacting the money they have to grow their business and compensate their employees. TriHealth's proposal would also increase health care costs for families, adding more financial strain for them during challenging times. We are proposing rate increases that continue to reimburse TriHealth at market-competitive rates and will stay at the negotiating table as long as it takes to reach an agreement. Quality care can and should be affordable—and the people and companies we serve deserve both."
What patients can do now
Dr. Metzger urges UnitedHealthcare members to apply for continuity of care and ask about out-of-network benefits while negotiations continue.
UnitedHealthcare told us they submitted a new proposal on Dec. 19 and are waiting on TriHealth's response.
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