UnitedHealthcare & HCA Healthcare Settles Contract Dispute

The disagreement, which had spanned several months, threatened to sever network coverage for UnitedHealthcare members in Texas, New Hampshire, South Carolina, and Denver.

UnitedHealthcare and HCA Healthcare, two of the largest entities in the US healthcare industry, narrowly averted a significant coverage disruption after resolving a protracted contract dispute just hours before a September 1 deadline. 

The disagreement, which had spanned several months, threatened to sever network coverage for UnitedHealthcare members in Texas, New Hampshire, South Carolina, and Denver.

The resolution ensures that 38 hospitals, affiliated locations, and physician groups within these regions remain accessible to UnitedHealthcare’s plan members. Without the agreement, members would have lost access to these facilities, significantly impacting patient care across these states.

Details of the Agreement

HCA Healthcare confirmed the settlement by saying, “After months of negotiations, we have reached an agreement with UnitedHealthcare. This means UnitedHealthcare plan members and their families will continue to have access to the convenient and quality healthcare they have come to expect from our care teams.” 

Moreover, the multi-year agreement covers employer-sponsored commercial plans, Medicare Advantage plans, and other market-specific plans. Certain plans have extended access to additional facilities and providers, ensuring broader coverage for members.

The dispute, publicized on UnitedHealthcare’s web pages, revolved around rate increases. In South Carolina, UnitedHealthcare had outlined demands for a 30% rate hike over two years, while in Texas, a 16% increase was sought in a single year. 

Additionally, these details were communicated through UnitedHealthcare's webpages and mailers, which also listed alternative providers where members could receive covered care if negotiations failed.

HCA Healthcare, however, challenged these claims, asserting that UnitedHealthcare had mischaracterized the rate demands. HCA contended that the insurer had proposed rates below the market average for many hospitals, leading to the prolonged stalemate.

Wider Implications

The agreement comes amid a series of publicized contract disputes involving UnitedHealthcare. 

Earlier this year, the insurer faced similar challenges with Mount Sinai and Trinity Health of New England, highlighting the increasingly contentious nature of contract negotiations in the healthcare sector.

HCA Healthcare, a major player with 186 hospitals and approximately 2,400 care sites, reported $65 billion in total revenues and $5.2 billion in net income in 2023. 

The resolution of the dispute with UnitedHealthcare, the nation’s largest private health insurer, is a critical development given the vast number of patients relying on continued access to care.

UnitedHealth Group, the parent company of UnitedHealthcare, reported revenues of about $370 billion and a profit of $22.4 billion last year. However, several contract negotiations have spilled into the public domain, raising concerns about the stability of healthcare coverage for its members.

While the resolution with HCA Healthcare provides relief for members in Texas, New Hampshire, South Carolina, and Denver, the situation remains tense in other regions.