UnitedHealthcare could terminate Houston Methodist Hospital System’s contract as an in-network provider, which would include the Baytown hospital, unless negotiations turn around before the end of the year.
The insurance company issued a statement saying it has been in negotiations with Houston Methodist for the last several months to renew their agreement while continuing to provide its members access to the hospital’s physicians and hospitals.
But if the two entities cannot come to an agreement by Jan. 1, Methodist’s hospitals would then be considered out-of-network while its physicians would follow on April 1. This affects the Houston Methodist Baytown Hospital as well as The Woodlands, Willowbrook, Sugar Land, Clear Lake, West Houston and downtown locations.
“Houston Methodist Baytown Hospital is honored to provide high-quality health care to Baytown and area residents and has been a community partner for more than 70 years,” Houston
Methodist Baytown CEO David Bernard said. “We are gravely disappointed in (United’s) short-sighted decision to terminate our contract. Of course, we continue to negotiate in good faith the end goal of securing a fair contract that preserves the in-network access for our community.”
Bernard added United might be responsible for “disrupting thousands of lives here.”
“And we hope these patients can continue receiving the care they deserve without leaving their community,” Bernard said.
Houston Methodist and United have a long-standing relationship that has lasted for more than 20 years. Hospital officials said when United abruptly decided to terminate the agreement and propose reduced rates, those terms could not be accepted and still provide the best possible care to the community.
United has also instructed its affiliate, Optum Health, which provides coverage for critically ill transplant patients, to not allow new patients to receive transplants and related care at Houston Methodist.
Hospital officials said this decision is harmful to its patients as well as the community since they would not have access to its nationally-recognized transplant program, the largest in Houston and the seventh-largest in the nation.
The hospital maintains that regardless of United’s decision, the hospital’s patients are still a top priority.
“They are at the center of all decisions we make,” hospital officials said in a statement. “Houston Methodist will not compromise our ability to provide high-quality patient care, invest in advanced technology and research, provide programs and services, and recruit and retain clinicians.”
The decision by United could force employers, as well as consumers, to consider different health care options in 2020, hospital officials said.
United provided its own statement about its decision concerning Houston Methodist.
“Care at Houston Methodist Hospital is significantly more expensive than some of the most prestigious hospitals in the country, including four of the top five hospitals in U.S. News & World Report’s rankings of the best hospitals in the United States. Houston Methodist is driving up the cost of health care for all Texans and the health care system overall.”
Some of the other hospitals on the U.S. News & World Report’s list include UT Southwestern Medical Center, Baylor St. Luke’s Medical Center, Baylor University Medical Center, and Memorial Hermann Greater Heights Hospital.
United also claims Houston Methodist is 49% higher than the average cost of those Texas hospitals.
“Methodist isn’t just the most expensive health system in Texas. It’s one of the most expensive in the entire country,” United stated.
United said Houston Methodist is 36% more expensive on average than four of the top five hospitals in a U.S. News & World Report 2019-20 rankings of the best hospitals in the country. Among those hospitals are Mayo Clinic, Massachusetts General Hospital, John Hopkins Hospital and the Cleveland Clinic. United said a CT scan at Houston Methodist Hospital costs $1,401 more – or 146% higher – than the average cost at those four hospitals.
“For people enrolled in our employer-sponsored health plans, the cost of care in Houston is more expensive than in any other city in Texas. In order to maintain a competitive business environment in Houston, we must get health care costs under control. And Methodist must be part of the solution,” United stated.
Bernard responded to United’s claim about its rates.
“We’d like to emphasize that this contract has been in place for 20 years,” Bernard said. “Houston Methodist will not agree to reduce the rates it receives for the high-quality care it provides - rates that UHC agreed to previously. United is disrupting the care for thousands of patients who seek us out for the quality health care we provide.”
Bernard added the rates are not as outrageous as United claims.
“Because insurance rates are confidential and private, we don’t know what other hospitals’ rates are, but we strongly believe, based on independent studies, that ours are in line with other hospital systems like ours in the Houston area,” he said.
For the latest information, a website and phone number are available for consumers that frequent Methodist hospitals, including the Baytown location, and have United and Optum Health insurance. Visit houstonmethodist.com/united or call 877-493-3228.
The hospital encourages its patients with United coverage to call the insurance company and request they keep Houston Methodist Baytown Hospital in-network. Patients can call the number on the back of their insurance card, 844-637-7503.