United Healthcare terminates contract with Houston Methodist; 100,000 plan members affected

[somarco]

Hospital provider contracts expire all the time. When it becomes public news, someone, usually the carrier, is hoping to leverage public reaction to bring the parties back to the bargaining table.

Most disputes are settled right before expiration. Some extend a day or so past the deadline. Usually the carrier will make public concessions with an announcement along the lines that "We will honor all claims during this negotiation period".

Keep in mind that both sides have much to lose by getting a divorce. These disputes are more grandstanding than anything. On rare occasion the separation will go on for months but most are settled.

 

[Northeast Agent]

Either way, sounds like a "free-for-all" this AEP and maybe OEP as well for Houston-area agents.

 

[Northeast Agent]

No contract in sight for Houston Methodist and UnitedHealthcare

Neither side appears to have budged in its negotiations, accusing the other of being unwilling to come to an agreement.

The prolonged fight between UnitedHealthcare and Houston Methodist takes place as other national insurers wrangle over rates with Houston-area health care providers.

 

[vic120]

vic120 said:

Don't know why it's 5 stars What does that mean?

I don't know what's so special about them there, but maybe someone from TX who sells UHC will jump in and tell us. I just have the license from working in a call center. Ironic after the kerfuffle going on about Houston today.

And with the (rare) 5 Star Plans, it creates an SEP for beneficiaries to change plans during Lock-In. The closest one to me is with KP now, in the DC Metro area. I think some Aetna plans are 4 or 4.5 Stars.

That's my point beyond creating a sep it really does not mean its a better plan than a 4 or even sometimes a 3-star plan

I believe the Ins company gets more money as well

but as far as conversations with clients I don't believe stars mean as much though unless its a low star rating then I am concerned but 3 or 4 stars can be a better plan than a 5 star

In fact in the past many times a 3 star has been better then a 4 star plan

 

[vic120]

Either way, sounds like a "free-for-all" this AEP and maybe OEP as well for Houston-area agents.

I don't know what exactly you mean as a free for all, I have had normal buis in TX, Aetna was very strong there this year as far as MA PPO,I did a bunch of Aetna PPO plans in TX

A couple UHC's and a very few Humana's and 0 Texan plus Med supp is by far my strongest product in TX though

 

[wehotex]

vic120 said:

Don't know why it's 5 stars What does that mean?

I don't know what's so special about them there, but maybe someone from TX who sells UHC will jump in and tell us. I just have the license from working in a call center. Ironic after the kerfuffle going on about Houston today.

And with the (rare) 5 Star Plans, it creates an SEP for beneficiaries to change plans during Lock-In. The closest one to me is with KP now, in the DC Metro area. I think some Aetna plans are 4 or 4.5 Stars.

I don’t claim to know about all of the Texas markets, but UHC is pretty dominant in San Antonio, El Paso and Corpus Christi. Each of these uses the Wellmed network that dominates in those areas. UHC is also dominant in DFW as well because of its vast network and longevity in the market.
It is maybe less dominant in Houston, but still does well, again because of its strong network. I’ll be really interested to see how dropping Methodist will affect that status.

 

[Thomas Mead]

I don’t claim to know about all of the Texas markets, but UHC is pretty dominant in San Antonio, El Paso and Corpus Christi. Each of these uses the Wellmed network that dominates in those areas. UHC is also dominant in DFW as well because of its vast network and longevity in the market.
It is maybe less dominant in Houston, but still does well, again because of its strong network. I’ll be really interested to see how dropping Methodist will affect that status.

UHC and Wellmed seem to be strong throughout Texas. My easiest MAPD sell in the DFW area is Care-N-Care since they were started by the 2 biggest hospital systems in the area and almost anyone within an hour that sees a specialist has one in the PPO network. They also have Texas Oncology in network now as well. I try to focus more on Supplements though.

 

[vic120]

I don’t claim to know about all of the Texas markets, but UHC is pretty dominant in San Antonio, El Paso and Corpus Christi. Each of these uses the Wellmed network that dominates in those areas. UHC is also dominant in DFW as well because of its vast network and longevity in the market.
It is maybe less dominant in Houston, but still does well, again because of its strong network. I’ll be really interested to see how dropping Methodist will affect that status.

Did a lot of UHC past few years in TX, This year just a few a lot more Aetna this year than in the past, People are looking more to PPO type plans this year, Aetna Hada good PPO in many area's this year

 

[vic120]

I don’t claim to know about all of the Texas markets, but UHC is pretty dominant in San Antonio, El Paso and Corpus Christi. Each of these uses the Wellmed network that dominates in those areas. UHC is also dominant in DFW as well because of its vast network and longevity in the market.
It is maybe less dominant in Houston, but still does well, again because of its strong network. I’ll be really interested to see how dropping Methodist will affect that status.

Actually going through my records now and I didn't write as many in TX as I thought but I did do a few Aetna and a few UHC, a little more Aetna, but Very Medsupp heavy in TX

I did a lot more MA in IL And NC and some IN, then I thought, mostly Aetna

 

[Northeast Agent]

Houston Methodist, major insurance company strike out on deal

Houston Methodist claimed UnitedHealthcare reduced previously negotiated rates for how much they charge for care.

As for UnitedHealthcare, it claimed Houston Methodist charged too much for services.

Both sides sent statements to ABC13 about the failed negotiations on New Year's Day.