About 8,000 UnitedHealthcare customers who get care from University of Chicago Medicine might have to switch doctors this summer — or pay significantly more for services because of a contract disagreement between the insurer and the medical system.

UnitedHealthcare — the state’s second-largest health insurer — and University of Chicago Medicine have been unable to agree on a contract to keep the medical center and the system’s doctors in the insurer’s network.

Both sides say in statements on their websites that they’re still negotiating. But they’re also warning that patients may no longer be able to get in-network care at the University of Chicago Medical Center or from University of Chicago Physicians Group after June 30 if no agreement is reached.

U. of C. Medicine sent letters to patients last week saying that UnitedHealthcare is ending its contract with the academic medical center and its physicians group after June 30. The letter warns that customers with PPO plans might have to pay greater portions of their bills and customers with HMOs will have to pay out-of-network rates for nonemergency care.

The letter, however, also says that UnitedHealthcare members undergoing “active treatment” might be able to continue getting care at in-network rates for a time. That may include people who are already in the hospital, many pregnant women, nonsurgical cancer patients, patients with end-stage renal disease, dialysis patients and symptomatic AIDS patients, according to the letter. Patients have to contact UnitedHealthcare to see if they qualify.

UnitedHealthcare customers in group retiree Medicare Advantage plans and Medicare Supplement plans will not be affected by the contract negotiations, according to UnitedHealthcare.

Representatives of UnitedHealthcare and U. of C. Medicine declined to discuss details of the disagreement.

But the insurer said in a statement that it remains “committed to working with University of Chicago officials on a new contract.”

“We recognize the important role University of Chicago plays in supporting the health care needs of our members, and our two organizations have met regularly over the last few months to reach a solution that will renew our relationship,” UnitedHealthcare said.

In an email, U. of C. Medicine spokeswoman Ashley Heher said, “The medical center is committed to making sure its care and expertise is available to as many people as possible, including about 8,000 UChicago Medicine patients who are currently covered by UnitedHealthcare’s commercial insurance plans.”

The uncertainty is sparking stress among patients.

Ivy Elkins, of Buffalo Grove, has been seeing her University of Chicago Medicine oncologist since she was diagnosed with stage 4 lung cancer more than three years ago. Elkins, 50, researched and carefully selected her doctor, and followed her to the University of Chicago from a different hospital system.

She’s unsure if she’ll qualify, as a cancer patient, to continue receiving care if the contract falls through.

“As a level 4 cancer patient, you build up this level of trust, and I trust her,” Elkins said. “Every decision she’s made for my health up to this point has been spot on, and I don’t want that to change in any way.”

lschencker@chicagotribune.com

Twitter @lschencker

Source

LEAVE A REPLY