Middlesex Hospital and United Healthcare failed to come to terms on a new contract by Aug. 1, which means that the Middletown hospital’s non-emergency services are out of network for UHC and Oxford health plans, both sides confirmed Thursday.
UHC said in an emailed statement that Middlesex is asking for a “significant premium for the care provided at its facility.”
“It is requesting rate increases that are unsustainable as we strive to offer our members access to high quality, affordable care in the state,” the statement said.
For the hospital’s part, CEO Vincent Capece Jr. said in a phone interview that a recent increase in the state’s hospital tax and pressure on Medicare and Medicaid rates means the hospital is forced to try to make up the difference from commercial payers.
“It’s the same as it always is — it’s economics.” Capece said. “There isn’t a hospital that hasn’t dealt with something like this.”
The two sides have been negotiating for several months, he said.
A statement on the hospital’s website says: “High quality health care and patient safety are not luxury items. Our patients and their families do not want us to compromise on their health care. We expect payers to feel the same way.”
UHC customers provided approximately $19 million in revenue to the independent hospital last year, according to Capece. Its total net patient service revenue from commercial health plans was just over $179 million in fiscal year 2014, according to state filings. That was about 45 percent of its overall patient revenue that year.
UHC Spokeswoman Maria Gordon-Shydlo said approximately 3,500 UHC customers have been to Middlesex Hospital in the past year.
Though not the hospital’s biggest insurance customer, Capece still described UHC as a “sizeable payer” and said he hopes the two sides can come to terms as soon as possible.
In the meantime, he said Middlesex has sent mailings and posted signs for UHC and Oxford patients warning them that they may have to pay out-of-network rates at the hospital.
Middlesex last signed a contract with UHC in 2012 — a deal that came at the midnight hour.
Earlier this year, Hartford Hospital and New Britain’s Hospital of Central Connecticut also nearly fell out of UHC’s network, but parent Hartford Healthcare and UHC reached a last-minute deal.
Correction: Due to erroneous information provided by United Healthcare, the original version of this story contained an inaccurate number of customers treated at Middlesex Hospital in the past year.
