UnitedHealthcare, Ascension Wisconsin agreement reached

UHC, Ascension Wisconsin agreement reached

UnitedHealthcare and Ascension Wisconsin on Tuesday announced they have reached a multi-year agreement, ending a weeks-long negotiations stalemate.

MILWAUKEE - UnitedHealthcare and Ascension Wisconsin on Tuesday announced they have reached a multi-year agreement, ending a weeks-long negotiations stalemate.

The backstory:

The deadline for the two companies to agree on a new contact was Oct. 1, but that didn't happen. It led to weeks of uncertainty for patients and providers and left human resources departments scrambling.

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UHC, Ascension announce deal

What they're saying:

In a statement, UnitedHealthcare said the agreement is effective immediately and retroactively to Oct. 1 for members enrolled in the following plans. They will experience no gap in coverage:

• Employer-sponsored and individual commercial plans
• Medicare Advantage plans, including Group Retiree and Dual Special Needs Plans (DSNP)
• UnitedHealthcare Community Plans in Wisconsin (Medicaid)

UnitedHealthcare, Ascension Wisconsin

Ascension Wisconsin said the new multi-year agreement secured "uninterrupted, in-network access to care for patients covered under UHC’s Commercial, Medicare and Medicaid plans."

With the agreement, Ascension Wisconsin said it held claims for services that took place between Oct. 1 and Oct. 13. Services received during that period will be covered at in-network rates, and patients should not be billed for out-of-network costs.

Contract dispute explained

Dig deeper:

Dan Sacks, a University of Wisconsin associate professor of risk and insurance, said it was a "surprise" to him that the stalemate lasted as long as it did.

"What's at stake in these contract disputes is essentially how much hospitals and doctors are going to get paid by insurers when you or I get care there," he said.

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Wisconsin patients were without in-network coverage for 13 days as UnitedHealthcare and Ascension Wisconsin continued to negotiate a new contract. Roughly 2,000 Milwaukee city workers alone were impacted. Sacks believes many displaced patients likely found coverage elsewhere.

"Anytime you have a disruption to your routine, you learn that it didn't work for you and there are better options," he said.

Specific details of the agreement were not made public. Sacks said these types of prolonged negotiations are common, but what is rare in this case is that the end result left so many patients in limbo for so long.

"There is an upside to having an insurer negotiating hard, which is that it might keep premiums lower than they otherwise would be," he said.

Official statements

What they're saying:

Statement from Dustin Hinton, UnitedHealthcare CEO of Wisconsin:

"We have reached a multi-year agreement that restores network access to Ascension Wisconsin for people enrolled in UnitedHealthcare commercial, Medicare Advantage and Medicaid plans, effective immediately. Our top priority throughout the negotiation was to reach an agreement that was affordable for consumers and employers, and this agreement helps accomplish that goal."

Statement from Daniel Jackson, Ascension Wisconsin CEO:

"This agreement is more than just a contract. It is a reaffirmation of our Mission to serve all with dignity and compassion. By securing fair and sustainable reimbursement, we are able to continue supporting our caregivers, strengthening our ministries, and providing high-quality, compassionate care across the communities we serve.

"We are grateful for the partnership and patience of those we serve as we navigated this important agreement. Together, we will continue our healing ministry and our commitment to the health and well-being of our communities."

Editor's note: This story was updated with additional information.