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May 20, 2024

Trinity Health Of NE, UnitedHealthcare battling over new contract

Photo | Joseph Driscoll Trinity Health Of New England's sign outside the Saint Francis Hospital and Medical Center Gengras Medical Office Building at the corner of Asylum Avenue and Woodland Street in Hartford.

Trinity Health Of New England and UnitedHealthcare are publicly fighting over a new contract to replace an agreement that expires at midnight on June 30.

Both organizations have posted messages about the negotiations on their respective websites, with each claiming they are keeping their customers’ best interests in mind.

“Our goal is to reach an agreement that is affordable and sustainable for the people and employers we serve while ensuring continued network access to the health system,” UnitedHealthcare’s post states.

Trinity Health Of New England counters on its website that it is trying to seek “new agreements that more adequately cover the cost of the care we provide to our patients with UnitedHealthcare Commercial and Medicare Advantage plans.”  

It is the second time this year that Trinity Health has fought publicly 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.

If the UnitedHealthcare contract expires, it would affect in-network access to the following Trinity Health Of New England hospitals, facilities, and health care providers:

  • St. Francis Hospital, Hartford
  • Mount Sinai Rehabilitation Hospital, Hartford
  • St. Mary's Hospital, Waterbury
  • Johnson Memorial Hospital, Stafford Springs
  • Mercy Medical Center - Springfield, Massachusetts
  • Trinity Health Of New England Medical Group locations and providers in Connecticut and Massachusetts

In a statement shared via email with Hartford Business Journal, UnitedHealthcare said Trinity Health issued a notice to end the contract and is demanding a more than 30% price hike over the next 24 months. The increase would affect its employer-sponsored plans in Connecticut and Massachusetts, the insurer said.

The two-page statement claims that Trinity Health’s proposal would increase healthcare costs by approximately $33 million for its employer-sponsored commercial plans and is “not affordable or sustainable.”

It also notes that the proposed increase is “more than double” the annual cost-growth benchmarks set by the state Office of Health Strategy (OHS). 

In January 2020, Gov. Ned Lamont signed Executive Order No. 5, which required OHS to benchmark the growth of total healthcare expenditures in the state. OHS, in consultation with a technical team and advisory committees, subsequently created an annual benchmark growth rate for healthcare spending. 

For 2023-25, the rate initially was set at 2.9%, but OHS said in February it was raising the benchmark to 4% due to “unusually high inflation occurring in the 2022 reporting year.”

UnitedHealthcare’s statement notes that Trinity Health Of New England is seeking to increase costs by more than twice that benchmark rate. It said the increases would significantly raise costs for self-insured customers, who represent 60% of its commercial members. A spokesman for UnitedHealthcare said approximately 27,000 members overall received services from a Trinity Health Of New England provider or facility in the past 12 months.

The insurer states that Trinity Health also is demanding special exceptions to UnitedHealthcare’s Medicare Advantage contract, something it does not have with any other health system in its network in Connecticut.

UnitedHealthcare’s statement adds that its goal is to keep Trinity Health Of New England’s hospitals and physicians in its network and affordable, and that it is proposing “meaningful rate increases” to ensure that the health system is “fairly and appropriately reimbursed at market-competitive rates similar to their peers throughout the state.”

Trinity Health Of New England also responded to a request for comment by sending a statement via email. It states that the health system is "committed to working with UnitedHealthcare to reach a fair agreement that appropriately covers the true cost of the care we provide our patients in Connecticut and Massachusetts who have Unitedhealthcare commercial and Medicare Advantage plans."

Trinity Health claims UnitedHealthcare continues to "not reimburse us fairly and deny or underpay claims, so they can use those dollars to bolster their own pockets and those of their shareholders."

It also states that the insurer "has not offered a contract that puts patients' health over their own wealth," and adds that UnitedHealthcare Group had "record profits of $22 billion last year."

According to filings with the Securities & Exchange Commission, UnitedHealthcare reported a net profit of $22.4 billion in 2023, up 11% from a year earlier. In the first quarter of 2024, however, the company reported a $1.4 billion loss, in part due to the financial impact of a cyberattack that disrupted business operations.

Trinity Health also states in its message that health insurers “often deny claims or fail to pay approved claims, leading to billions of dollars left unpaid” to health systems. It said such denials cost Trinity Health $120 million per year.

UnitedHealthcare said it has informed its members that even if the contract with Trinity Health Of New England expires, it still has “more than 1,000 physicians” and several hospitals in its network, including Hartford Hospital, Midstate Medical Center in Meriden, Prospect Manchester Hospital, Rockville General Hospital in Vernon, and Waterbury Hospital, as well as Holyoke Medical Center in Massachusetts.

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