JACKSONVILLE, Fla. – UnitedHealthcare and Ascension Florida have reached a “verbal agreement” to extend their contract through May 14 as both sides continue negotiations to keep Ascension Florida hospitals in UnitedHealthcare’s network.
The organizations originally had until May 1 to reach an agreement, but Tuesday’s announcement gives patients at least two more weeks to see how the negotiations unfold.
If an agreement isn’t reached on May 14, the potential breakdown would impact patients with the following UnitedHealthcare plans:
- Medicare Advantage, including Dual Special Needs Plans (DSNP) and Group Retiree plans
- Employer-sponsored commercial plans
- UnitedHealthcare Community Plan (Medicaid)
Ascension Health operates four hospitals across Northeast Florida, including locations in Riverside, Southside, Clay County and St. Johns County.
Local patient Charlie Guy, who relies on UnitedHealthcare, says the ongoing uncertainty is creating chaos for those who are already facing limited healthcare options.
“I have diabetes, high blood pressure, and now my primary doesn’t even know where to send a referral because Shands isn’t accepting UnitedHealthcare,” Guy explained. “And now they’re saying Ascension won’t be either.”
According to UnitedHealthcare, UF Health opted out of the network by not responding to ongoing negotiations.
“You don’t have any specialists at Shands. You don’t have any specialists at Ascension,” Guy said. “You have to travel who knows where — Orange Park, Southside — and not everyone has the transportation or money to do that.”
A local physician and financial planner, Dr. Carolyn McClanahan, says these contract disputes leave patients caught in the middle.
“When you sign up with your insurance company, your doctor usually is in your network, the hospitals you like to go to are in your network, and everything’s good,” McClanahan said. “But oftentimes, doctors and hospitals and the insurance companies renegotiate the contracts, and when that happens, sometimes they don’t agree, because the doctors and hospitals want more money, the insurance companies don’t want to pay it, and so your doctor in your hospital may be kicked out of your network. So who’s left to suffer? It’s the patients.”
Guy fears that if no agreement is reached, patients could be left paying out-of-pocket for services they can’t afford.
“What happens to our current care?” Guy asked. “We’re gonna have to pay out of pocket, and what happens if we can’t afford to pay out of pocket?”
“This is another data point on how broken our healthcare system is. Insurance companies make a huge profit, hospitals and doctors do pretty well, and the cost of care just keeps going up, and those premiums are passed through to the consumer,” McClanahan said.
Patients currently undergoing treatment may qualify for continuity of care, which allows some to continue receiving care at the same facility for a limited time, even after providers go out of network.
Qualifying cases may include:
- Women who are pregnant
- Patients undergoing active cancer treatment or recently diagnosed
- Others receiving complex ongoing care