Just days before a contract cutoff date, UnitedHealthcare and Northside Hospital are moving toward a deal that would keep three of the Atlanta-based system’s... Northside, major insurer near deal to resolve contract disputes

Just days before a contract cutoff date, UnitedHealthcare and Northside Hospital are moving toward a deal that would keep three of the Atlanta-based system’s hospitals in the insurer’s network.

An agreement also would bring Northside’s hospitals in Lawrenceville and Duluth back into the insurer’s fold after five months out of network, a UnitedHealthcare official said.

“We are working closely with Northside to finalize the contract and hope to be ready to announce the agreement soon.” Cole Manbeck, a United spokesman, said Tuesday.

A letter of agreement has been signed between the two parties, which are now working out the exact terms of the deal, Manbeck said.

The agreement, as is, will mean uninterrupted access for United members to Northside’s hospitals in Atlanta and suburban Cumming and Canton. And eventually, a contract will add Northside’s Lawrenceville and Duluth hospitals for the first time to United’s Medicare Advantage network.

A deal would renew a relationship that sometimes looked to be on shaky ground the past month. The impasse sparked concerns among thousands of United members who use Northside providers.

“Northside and UnitedHealthcare have made excellent recent progress in our negotiations,’’ Lee Echols of Northside Hospital said Tuesday. “We look forward to culminating the process. Our patients throughout the Atlanta region are the big beneficiaries, and we hope that the work we’ve done reflects that.”

Northside Hospital Atlanta is an important feature for insurers’ networks, with a reputation of delivering more babies a year than any other community hospital in the country.

Most contracts OK’d at last minute

A contract lapse between an insurer and a hospital system is unusual, with many agreements hammered out just before the renewal deadline.

Northside Gwinnett

But after Northside’s facilities in Gwinnett went out of network, Taylor Carrion, 31, of Buford became worried. She’s a United member whose doctors remained in the insurer’s network. Yet going to Northside Hospital Gwinnett, in Lawrenceville, would have cost her much more to get care.

Without a contract, she said, “if I do decide to have a baby, I’m stuck.’’ During the impasse, she had phoned both the hospital and United to express her concerns.

Carrion called an impending contract deal “great news.’’

Northside Hospital acquired the former Gwinnett system, including the Lawrenceville and Duluth hospitals, in 2019. Gwinnett is the second most populous county in the state.

United had slammed Northside prices

During the dispute, United criticized what it called high prices at Northside facilities.

In a statement last month to GHN, the Minnesota-based insurer said that “Northside’s Atlanta, Cherokee [Canton] and Forsyth [Cumming] hospitals are the most expensive in Atlanta, and for cancer patients, they’re some of the most expensive places in the entire country to receive care.’’

Northside Hospital Atlanta

 

United accused Northside of marking up the cost of physician-administered drugs, “padding its bottom line at the expense of its patients.’’

“Despite these high costs, Northside is demanding a double-digit price hike over the next three years that would significantly increase health care costs,’’ the United statement continued.

Even with such heated language during the dispute, Josh Berlin, CEO of the consulting firm rule of three, said it wasn’t surprising that a contract deal was reached.

“Northside and United striking an agreement is good for the Northside community served, and a must for United’s market presence given the number of insured lives in play,’’ Berlin said, citing increasing competition in metro Atlanta.

“United needed to finalize this arrangement to maintain its competitive positioning in the market.’’


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Andy Miller

Andy Miller is editor and CEO of Georgia Health News

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