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Battle between Ascension, UnitedHealthcare
A contract battle is brewing between one of the nation's largest insurers and a major Wisconsin hospital system.
BROWN DEER, Wis. - In less than one month, patients could be paying more out of pocket for their medical care as a contract battle brews between one of the nation’s largest insurers and a major Wisconsin hospital system.
What we know:
The fight is between Ascension Wisconsin and UnitedHealthcare.
Many patients received letters from Ascension warning that if the two sides don’t reach an agreement by Oct. 1, Ascension facilities will become out-of-network for UnitedHealthcare members.
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Contract negotiations are standard, as hospitals and insurers agree on what insurers will pay for patient services. But the two say they remain far apart.
Dig deeper:
Dan Sacks, an associate professor of risk and insurance at the University of Wisconsin–Madison, said both sides have something to lose.
"If United drops them, it's going to be really expensive for them to go to Ascension, when it's not in-network or it's not even covered," Sacks said. "From Ascension's perspective, that means that they're going to see far fewer patients."
Sacks added that United also risks losing business if patients seek other insurers with broader networks.
"United potentially risks losing that business, not tomorrow, but in the future if they provide a competitive network," he said.
Ascension argues UnitedHealthcare is not offering high enough rates, especially when factoring in inflation. United counters that Ascension’s demands would raise costs for patients.
If the two separate, Ascension recommends patients check with their HR representatives or review open enrollment options to stay with Ascension providers. UnitedHealthcare says patients will still have access to other in-network hospitals in the region.
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Big picture view:
Sacks said there could be a silver lining.
"I hope that some people will also take it to reconsider some of their options and they may just find actually that there's a better insurance plan for them or a better healthcare provider option for them," he said.
A United spokesperson said patients already in treatment at an Ascension facility may qualify for "continuity of care" coverage for a specific time period if the contract ends.
For a list of frequently asked questions, visit UnitedHealthcare's website.
The Source: FOX6 News obtained the letter from Ascension Wisconsin.