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UnitedHealthcare, Ascension WI stalemate
"Unaffordable and unprecedented," that's how human resource experts are describing the dilemma between Ascension and UnitedHealthcare and now, HR departments are scrambling.
MILWAUKEE - "Unaffordable and unprecedented," that's how human resource experts are describing the dilemma between Ascension and UnitedHealthcare.
The two companies have not agreed on a contract, so Ascension Wisconsin is no longer in network with UnitedHealthcare.
Now, human resource departments are scrambling.
Ascension
How it impacts HR departments
What we know:
"I think the timing of this is pretty unprecedented," said Alisa Nagle, Assistant Professor of Management at Marquette.
Nagle has years of HR experience, but the UnitedHealthcare and Ascension stalemate is new territory.
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UnitedHealthcare, Ascension Wisconsin negotiations at standstill
One week and still no health care coverage. Ascension Wisconsin and UnitedHealthcare have not agreed on a contract.
"I have never been in a situation where it is this late in the plan year. When employers are again days, weeks, months away from open enrollment with a brand-new plan year coming up," added Nagle.
The deadline for the two companies to agree on a contract was Oct. 1.
Since that hasn't happened, Ascension is no longer in-network for UnitedHealthcare.
Some of the advice: wait for open enrollment. But that might also be a bust.
UnitedHealthcare
"These are HR departments who were confident going into open enrollment that they had a good deal with UnitedHealthcare. I think they are scrambling," said Nagle.
Nagle says employers likely negotiated plans with United months ago.
With open enrollment for a lot of companies weeks away — time is up.
"At this point, they are kind of out of options. Some may be able to pretty quickly negotiate a plan, negotiate premiums with another healthcare plan. Some may not," said Nagle.
How to navigate the situation
What you can do:
Nagle says larger employers might offer multiple healthcare plans with different insurance providers.
Small companies may not have as many options.
It also depends on the specific plan you are enrolled in.
"Work with your employer to determine if there is a continuity of care option here offered through that particular plan. If there is, that buys you a couple of weeks or months," said Nagle.
Alisa Nagle
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Nagle says you can also try looking at the marketplace for insurance...
But that's pricey, as the standstill leaves patients in a tough spot.
Ascension Wisconsin no longer in-network with UnitedHealthcare
Ascension Wisconsin is no longer in-network with UnitedHealthcare, effective Oct. 1, 2025.
Both companies say they are continuing the negotiations.
Previous statements
What they're saying:
Ascension Wisconsin statement
"Ascension Wisconsin has been engaged in negotiations with UnitedHealthcare for several months in an effort to reach a fair and sustainable agreement that supports continued access to quality care for the UnitedHealthcare Commercial, Medicare and Medicaid members we serve. Despite our best efforts, we were unable to come to terms that reflect the rising cost of delivering care in today’s environment."
"As a result, effective October 1, 2025, Ascension Wisconsin is no longer in-network with UnitedHealthcare. This impacts patients receiving care at our hospitals, outpatient facilities and physician practices, as well as associated practices of Ascension Medical Group."
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Ascension, UnitedHealthcare battle puts Wisconsin patients at higher bill risk
Ascension Wisconsin and UnitedHealthcare are in contract negotiations, with Ascension warning it could go out-of-network Oct. 1.
"Over the past several years, our caregivers have worked through extraordinary challenges to continue delivering compassionate, quality care, while health insurers like UnitedHealthcare have posted record profits. The reimbursement rates UnitedHealthcare proposed do not adequately account for the significant financial pressures facing healthcare providers, including unprecedented inflation, and rising costs for equipment and medications. These pressures are straining the healthcare system nationwide, and we must ensure we have the resources necessary to maintain and advance the high standards of care our patients expect and deserve."
"We recognize this change may be disruptive and concerning for our patients. We are committed to helping those affected understand their options and continue accessing the care they need. Patients may still be able to receive care from Ascension Wisconsin providers on an out-of-network basis or may have additional choices during open enrollment."
'While our current agreement with UnitedHealthcare has not been renewed, our commitment to delivering compassionate, quality care to the communities we serve remains unchanged. We continue to believe that fair, sustainable insurance contracts are critical to the long-term health of our patients and the healthcare system—and we remain open to resuming discussions with UnitedHealthcare should they be willing to engage in a way that supports that goal."
UnitedHealthcare statement
What they're saying:
"Despite repeated efforts to reach a compromise, Ascension Wisconsin (Ascension) has chosen to leave our network. Ascension refused our latest proposal, which would have continued to reimburse the health system at market-competitive rates, and declined another request to extend our contract to allow additional time to negotiate."
"As a result, Ascension’s providers and hospitals in Wisconsin are out of network for people enrolled in the following plans, effective Oct. 1, 2025:
- Employer-sponsored and individual commercial plans
- Medicare Advantage plans, including Group Retiree and Dual Special Needs Plans (DSNP)
- UnitedHealthcare Community Plans in Wisconsin (Medicaid)
"Optum Behavioral Health is not impacted by this negotiation and will continue to remain in-network with Ascension Wisconsin."
"Our goal throughout this negotiation has always been to reach an agreement that is affordable for consumers and employers while maintaining continued, uninterrupted network access to Ascension. We made numerous compromises, including proposing rate increases that would have continued to reimburse Ascension at market-competitive rates."
"Unfortunately, Ascension refused to move off its demands for unsustainable price hikes that would have increased health care costs for Wisconsin families and businesses."
"We proposed multiple times to extend our current contract—even as recently as Sept. 30. This would have provided our members continued network access to Ascension while we continued our discussions. Ascension refused and chose to disrupt access for its patients, presumably as leverage to help obtain the price hikes they are seeking."
"While we remain open to discussions with Ascension, our primary focus at this time is providing the members we serve uninterrupted access to the care they need through either continuity of care or supporting them as they transition to new care providers. We know that network changes can be difficult, but our members can rest assured that they will continue to have access to high-quality, affordable care from our broad network of hospitals and physicians."
The Source: FOX6 spoke to an assistant professor at Marquette to produce this story. Information in this post was also provided by Ascension Wisconsin, UnitedHealthcare and previous coverage.