CINCINNATI — After over a year of negotiations, TriHealth and UnitedHealthcare (UHC) have reached an agreement, according to a statement from TriHealth.
The companies were caught in a contract dispute over payment rates and claim denials, with both sides presenting different versions of the conflict.
TriHealth said it asked for fair reimbursement that would cover the cost of care to maintain its population health model, claiming UHC "has not been a good partner."
UHC said TriHealth's requests included "significant price hikes" that would burden local employers and claimed approximately 90% of Cincinnati employers self-fund their health plans, meaning rate increases directly impact businesses. UHC also maintained that TriHealth's proposal would increase healthcare costs for families during challenging times.
In addition to reimbursement, TriHealth said it was seeking to reduce "administrative red tape" so medical staff could spend more time on patient care and less time on paperwork.
WATCH: We spoke to patients during the ongoing dispute between TriHealth and UHC
If the two didn't reach an agreement by Dec. 31, thousands throughout the Tri-State could have faced higher medical costs, limited coverage, disruptions to ongoing treatments and possible provider changes.
In Wednesday's announcement, TriHealth said the agreement ensures TriHealth hospitals, outpatient centers and physicians will remain in-network for those served through UHC employer-sponsored, Medicare Advantage, and Medicaid health plans.
"We are grateful for the opportunity to continue caring for the roughly 80,000 of our patients who have been affected by these negotiations and look forward to strengthening our relationship with UnitedHealthcare moving forward,” said TriHealth President and CEO Mark C. Clement.
Taylor Nimmo has been covering this story for WCPO. You can contact her here:
The agreement will allow for continued care for UHC Commercial, Medicare Advantage, Veteran Affairs Community Care Network and Medicaid patients, with patients able to continue scheduling appointments as usual, according to a statement from UHC.
"We are honored to continue supporting all of the people throughout Cincinnati who depend on us for access to quality and affordable health care," a spokesperson for UHC said.
Patients with additional questions can visit Trihealth.com/UHC.
