Health Care & Insurance  August 23, 2023

Boulder Community Health, United Healthcare contract stalemate risks patient coverage

BOULDER — If Boulder Community Health and United Healthcare Service LLC can’t come to an agreement on terms for a contract extension, patients at the hospital with UHC insurance coverage may soon have to pay out of pocket or find doctors elsewhere, BCH warned patients in a letter this week. 

“BCH and UHC’s current contract will expire on Sept. 30, 2023. Both BCH’s and UHC’s senior leadership teams have been working diligently to negotiate a contract renewal in order to provide you with in-network access to BCH services, but we have not been able to agree upon acceptable terms that support BCH s financial sustainability,” according to the letter, which was signed by BCH chief medical officer Ben Keidan. “Failure to reach an acceptable agreement will result in BCH s termination of all commercial and Medicare Advantage contracts with UHC for services provided at BCH facilities and by our employed physician network.”

Should contract negotiations fail, “BCH-employed physicians and advanced care providers, hospital-based services and our facilities including Foothills Hospital will be out-of-network on and after Oct. 1, 2023,” a frequently-asked-questions page on BCH’s website said. That page also lists the individual BCH-affiliated practices that will be out-of-network should the contract terminate.

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BCH sent BizWest an emailed media statement Wednesday afternoon with language from the FAQ. BizWest sent a series of follow-up questions related to whether the hospital hopes to reach an agreement with UCH before the September deadline, if there’s a date in advance of that deadline when negotiations will be halted, and when patients will be notified if there is no contract extension. United Healthcare did not respond to requests for comment. This story will be updated if and when new information is available. 

BCH said that it has already “sent a termination notification to UHC since neither party can agree to acceptable terms for services provided at BCH.”

The nonprofit hospital organization “is dependent on fair rate increases to remain financially stable,” Boulder Community Health said. “BCH does not want to terminate this contract, however UHC’s current proposal is significantly lower than the general inflation rate. Like most industries, health care is experiencing significant adverse financial impacts related to the pandemic combined with rapid increases in costs for labor, supplies and other expenses. Increasing the financial burden on hospitals and their providers exacerbates the pressure and burnout health care workers are experiencing.”

BCH’s website encourages potentially impacted patients to contract UHC and to “let your employer know how important it is for BCH providers to remain in-network.”

BCH’s letter to patients has caused a stir among patients, some of whom have taken to social media with concerns that they will have to drive to farther-away hospitals, even in the case of life-threatening emergencies, or pay higher out-of-pocket expenses. This is not necessarily true in all cases.

“Colorado law and the federal No Surprises Act ban out-of-network cost-sharing (like out-of-network coinsurance or copayments) for most emergency and some non-emergency services,” according to the Colorado Department of Insurance. “You can’t be charged more than in-network cost-sharing for these services.”For more information, visit the No Surprises Act website.

Lucas High
A Maryland native, Lucas has worked at news agencies from Wyoming to South Carolina before putting roots down in Colorado.
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