Trinity Health contract with UnitedHealthcare expires with no new agreement

HBJ FILE PHOTO St. Francis Hospital is part of Trinity Health Of New England.

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Trinity Health Of New England is no longer part of UnitedHealthcare’s network after the contract between the two organizations ended without a new agreement.

The previous contract expired at midnight June 30. A spokesman for UnitedHealthcare said in May that approximately 27,000 members overall had received services from a Trinity Health Of New England provider or facility in the past 12 months.

In a statement emailed to Hartford Business Journal, Trinity Health said "a cooling off period" will continue to provide in-network access to Saint Francis Hospital and Mount Sinai Rehabilitation Hospital in Hartford, Saint Mary’s Hospital in Waterbury, Johnson Memorial Hospital in Stafford Springs, and Mercy Medical Center in Springfield, Massachusetts through Aug. 31.

Trinity Health Of New England Medical Group physicians, however, are out of network with UnitedHealthcare as of July 1, it added.

UnitedHealthcare said the "cooling off" period applies only to Trinity Health of New England’s hospitals for ASO and fully insured commercial members

Trinity Health of New England’s physicians are now out of network for the following benefit plans:

Employer-sponsored commercial plans, including fully insured and ASO.
Medicare Advantage plans, including Group Retiree.
Medicaid plans, including the Dual Special Needs Plan (DSNP).

Trinity Health’s hospitals are now out of network for the following UnitedHealthcare benefit plans:

Medicare Advantage plans, including Group Retiree
Medicaid plans, including the DSNP.

"This outcome is deeply disappointing," Trinity Health said in the emailed statement. "Over the last many months, Trinity Health Of New England to reach a fair agreement that appropriately covers the true cost of care we provide." It added that it still wants "to work with UnitedHealthcare to reach a fair agreement and will continue to contact them."

UnitedHealthcare also provided a statement via email, stating that Trinity Health Of New England "refused to move off its demands for a more than 30% price hike that would take effect over the over the next 24 months for our employer-sponsored commercial plans. Agreeing to this would significantly drive up health care costs for Connecticut and Massachusetts families as well as employers and is not sustainable."

It added that UnitedHealthcare remains "committed to continued discussions that would ensure Trinity Health Of New England continues to be reimbursed at market-competitive rates. However, our focus now 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 provider, as appropriate.”

Both companies have posted more detailed statements on their websites. Trinity Health's statement can be found here, while UnitedHealthcare's can be found here.

This is the second time this year that Trinity Health has publicly fought over a contract with an insurer. In February, it reached an agreement with Cigna that took effect March 1 to replace a contract that expired on April 30.