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Northwest Healthcare now considered out of network for UnitedHealthcare patients

Posted at 11:28 AM, May 01, 2017
and last updated 2017-05-02 12:52:26-04

After failed contract negotiations, Northwest Healthcare facilities are now considered out of network for UnitedHealthcare patients.  

Monday morning both companies announced they were not able to come to an agreement on a contract before it expired. 

This means those with UnitedHealthcare will now have to pay out of pocket to visit physicians Northwest facilities. For some this will mean finding new doctors at different hospitals in Tucson. Doctors urge people to continue to go to the nearest hospital in the event of an emergency, as it will still be considered in-network.

United says this may impact about 46,000 patients in southern Arizona. United covers about 2 million people in the state.

If you are pregnant and are in or entering your 2nd or 3rd trimester, if you have cancer, or if you already have some type of procedure scheduled you can apply for "continuity of care" benefits. That may help you stay with the doctor you have. 

Both sides have given different accounts as to what happened.

Below is a statement from Lisa Contreras, the regional communications directed for United: 

Late Sunday night, Northwest Healthcare's parent company, Community Health Systems (CHS), decided to not renew its contract with UnitedHealthcare. As a result, beginning May 1, 2017, Northwest Healthcare will no longer be an in-network care provider for employer-sponsored, individual, Medicare Advantage and Medicaid health plans.  

Despite numerous attempts over the weekend to reach an agreement and significant compromises in our proposal, Northwest Healthcare and CHS turned down our offer for a five-year agreement that would have kept the system's hospitals, ambulatory clinics and physicians practices in our network.  

The care Northwest Healthcare provides is not only important; it is personal to residents living in northwest Tucson. UnitedHealthcare remains focused on members' continued access to care for those who are currently being treated by a Northwest Healthcare physician, or at a Northwest Healthcare facility. Members who are currently ongoing treatment with a Northwest Allied physician or specialist can call the number on their health insurance ID card to request a Continuity of Care benefit. Other Tucson hospitals and physician practices are supportive and prepared to accept our members for care. 

For more than 20 years, we've been working with the Arizona community to ensure residents have access to a broad network of care providers. UnitedHealthcare's goal remains to find an acceptable solution that would renew in-network access to the health system's hospitals and physicians with a contract focused on quality, affordable health care. 

Below is a portion of the statement from Northwest: 

As of May 1, 2017, all Northwest Healthcare facilities, urgent care locations, and physicians, are out of network for all patients with United health insurance.

Despite our repeated efforts to find common ground over the last several months, United made it clear they would rather compromise your access to the Northwest facilities and providers you selected than work together to reach an agreement.

Instead of working with us to preserve patients' access to the health network they trust, United has made misleading statements.

You can read the full statement here

Both Northwest and United have launched competing websites to give customers information during contract negotiations. 

Northwest says it has sent out about 60,000 letters over the past 15 months to inform patients of the situation. 

Impacted hospitals and urgent care facilities include:

Northwest Allied Physicians
Northwest Medical Center
Northwest Urgent Care
Continental Reserve Urgent Care
La Paloma Urgent Care
Northwest Urgent Care, Duval Mine
Northwest Urgent Care, Orange Grove
Northwest Urgent Care, Speedway
Oro Valley Hospital
Rancho Vistoso Urgent Care
QuickMed Clinics
QuickMed Valencia
QuickMed Swan
QuickMed Tangerine
Northwest Emergency Center Vail
Desert Cardiology, Heart Center of Southern Arizona and Northwest Heart & Vascular
Tucson Surgery Center
Center for Pain Management
Northwest Tucson Surgery Center

Dr. Susan Kalota, the president of the Pima County Medical Society, released the following statement: 

As southern Arizona’s largest not-for-profit physician organization we’re profoundly disgusted with Northwest and United Healthcare’s inability to reach an agreement. Thousands upon thousands of patients will now find their primary doctors considered as “out-of-network” physicians. They will also be barred access to urgent-care facilities and two of this community’s major hospitals – Northwest Medical Center and Oro Valley Hospital.

It’s truly a sad state of affairs when patients find themselves marginalized, ignored in situations such as this.

Both sides say they want to continue the negotiations.