As of July 1 2019, Boca Raton Regional Hospital is no longer in the network of United Healthcare, America’s largest health insurance provider with over 70 million subscribers. The two parties have not been able to come to an agreement and on July 2 2019, UHC officially removed BRRH from its online list of “In-Network” hospitals. Thousands of Boca residents are affected. For status updates, call BRRH at 561-955-7100.
The Epic Failure
I recall BRRH leadership, saying at one time (my paraphrase), that they did not want patients to bypass Boca to receive services at competing hospitals. So they expanded the scope of many critical services, turned our community hospital into a regional hospital, and sold it to Baptist Health, a major hospital chain. The ultimate result? Thousands of residents will have to bypass Boca to receive hospital medical care. An epic strategic failure.
The Effects Will Be Enormous
BRRH still accepts UHC insurance, but the in-network discount is no longer applied. So, United subscribers will now have to go outside of Boca Raton to receive hospital services, both in-patient and out-patient.
BRRH doctors may or may not be affiliated with other facilities. This may mean UHC patients will need to find new doctors to serve many of their needs. As well, doctors ,may lose many of their patients.
To their credit, UHC has “Continuity of Care” where members undergoing treatment such as chemo or radiation as of July 1 2019 may still qualify for in-network costs. But long term, UHC subscribers will have to find new hospital service providers for those types of treatments. Maternity services at BRRH Boca will disappear for United subscribers. The list of services is long, and the implications are huge.
UHC member services confirmed to BocaFirst that UHC subscribers will be faced with much higher medical bills if transported to BRRH even for emergency care. They also said UHC subscribers can switch plans to one that includes BRRH only if their employer offers one. While a special “Gap” clause exists that allows out of network hospitals, its only when there is no other hospital within 30 miles. TheUHC criteria is based on miles not the time it takes to get through traffic.
On the business side, BRRH’s revenue could drop dramatically while competing hospitals’ revenue increase accordingly.
The Bitter Irony of Boca Raton Regional Hospital
The Boca Raton Community Hospital was founded in 1967 after Gloria and Robert Drummond’s two children died of poisoning because the closest facilities were outside of town. We needed and wanted a hospital centrally located in Boca Raton, and the “Miracle on Meadows Road” came into existence. Now, once again, thousands of Boca residents will be dependent on out-of-town hospital services.
United Healthcare boasts it is the “largest single health carrier in the United States” and arranges for discounted access to “more than 6,000 hospitals and other facilities”. Boca Raton Regional Hospital under the Baptists Health Family uses the slogan “We are Healthcare that Cares”.
There’s only losers here. United Healthcare loses if subscribers drop them. Boca Raton Regional Hospital loses patients. Boca Raton residents face the decision to increase their healthcare costs or lose their “Miracle on Meadows Drive” and return to the days of the early 20th century. Boca Raton loses as a less desirable community in which to live.
This is a screen capture from the UHC website of In-Network hospitals for its subscribers: