News Summary

In New Orleans, thousands of UnitedHealthcare members may face higher costs and limited access to healthcare due to a contract dispute with LCMC Health. If unresolved by November 1, 2023, many members could find LCMC hospitals out of their insurance network, impacting around 30,000 patients. The dispute centers on reimbursement rates, with both organizations at an impasse. As discussions proceed, patients need to stay informed about their healthcare options and the potential implications for their coverage.

New Orleans Faces Healthcare Access Crisis Amid UnitedHealthcare and LCMC Health Contract Dispute

Thousands of UnitedHealthcare insurance members in New Orleans are at risk of facing higher costs and limited access to essential healthcare services due to an ongoing contract dispute with LCMC Health. If an agreement is not reached by November 1, 2023, many UnitedHealthcare members will find LCMC hospitals in Metairie, Westbank, New Orleans East, and downtown New Orleans out of their insurance network, which could lead to significant out-of-pocket expenses for care.

The negotiations between the two organizations center on reimbursement rates for services rendered at LCMC’s facilities. Presently, the dispute is impacting patients who are covered through employer-provided insurance or through the Affordable Care Act exchange, with estimates indicating that approximately 30,000 patients could be affected. This could result in patients having to incur out-of-network charges for services received at LCMC hospitals, even if their scheduled doctor visits take place there.

Details of the Dispute

LCMC Health claims that UnitedHealthcare is proposing reimbursement rates that do not keep pace with inflation. In contrast, UnitedHealthcare contends that its rates are competitive relative to others in the market. In an effort to expedite the negotiations, LCMC Health recently published a two-page advertisement encouraging resolution of the discussions.

Dr. Mark Kline from LCMC has expressed concerns about the implications of failing to reach an agreement, highlighting that all hospital services and multiple physician networks would be impacted as of November 1, 2023. In such a scenario, patients undergoing long-term care would need to begin a “continuity of care program” with UnitedHealthcare to avoid facing out-of-network costs.

Background on LCMC Health and UnitedHealthcare

LCMC Health operates eight major hospitals across the metro New Orleans area. Despite a steady increase in operational costs, the organization has reported stagnant reimbursement rates, adding stress to their financial sustainability. On the other hand, UnitedHealthcare is the second-largest health insurer in Louisiana, covering nearly one million clients, with about 70% of its customer base insured through employer benefits.

The current contract between UnitedHealthcare and LCMC Health will remain effective until October 31, 2025. However, the present dispute could mirror a broader trend observed in healthcare contract negotiations, highlighting challenges faced by healthcare providers and insurers alike. Industry experts warn that healthcare costs are expected to continue rising, regardless of the outcomes of localized disputes.

Implications for Patients

Should the negotiations fail, patients on Medicare Advantage or Medicaid will remain unaffected. However, those covered by commercial health plans could experience significant changes to their coverage options, which may impact their overall access to healthcare. Many UnitedHealthcare members who rely on LCMC facilities for their medical needs are now left to grapple with the uncertainty of their current healthcare situation.

It is essential for impacted patients to stay informed about the negotiations and to consider their healthcare options as the deadline approaches. As discussions continue, the focus remains on finding a resolution that benefits both organizations while ultimately prioritizing the health and well-being of the thousands of patients who depend on these valuable healthcare services.

Deeper Dive: News & Info About This Topic

• WWLTV: Thousands Could Lose Affordable Access to LCMC Hospitals
• Wikipedia: Healthcare in the United States
• NOLA: UnitedHealthcare and LCMC Contract Dispute
• Google Search: UnitedHealthcare Contract Dispute 2023
• WWLTV Video: Thousands Could Lose Access Amid Contract Dispute
• Encyclopedia Britannica: Health Care
• PR Daily: UnitedHealthcare CEO’s Death Could Change Corporate Comms
• Google News: LCMC Health UnitedHealthcare

Author: STAFF HERE NEWORLEANS WRITER

The NEW ORLEANS STAFF WRITER represents the experienced team at HERENewOrleans.com, your go-to source for actionable local news and information in New Orleans, Orleans Parish, and beyond. Specializing in "news you can use," we cover essential topics like product reviews for personal and business needs, local business directories, politics, real estate trends, neighborhood insights, and state news affecting the area—with deep expertise drawn from years of dedicated reporting and strong community input, including local press releases and business updates. We deliver top reporting on high-value events such as French Quarter Festival, New Orleans Jazz & Heritage Festival, and Essence Music Festival. Our coverage extends to key organizations like the New Orleans Chamber of Commerce and Greater New Orleans, Inc., plus leading businesses in energy, healthcare, and education that power the local economy such as Entergy, Ochsner Health, and Tulane University. As part of the broader HERE network, including HEREShreveport.com, we provide comprehensive, credible insights into Louisiana's dynamic landscape.