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Boca Regional and UHC: Going, Going, Gone!

by Joe Panella

Here’s the latest regarding the breakdown in negotiations between United Healthcare and the Boca Raton Regional Hospital. For background information on this topic, see our previous articles on bocafirst.org.

First a quick recap

July:  Two things happened simultaneously. One is that Boca Raton Regional Hospital (BRRH) merged with Baptist Health of South Florida. On the same day the merger was announced, UHC’s contract with BRRH expired, forcing some 17,000 subscribers to different physicians and hospitals.  Pundits argued that letting the contract expire was merely a negotiating tactic.  They were wrong.

October:  This is the month that Baptist Health starts a new fiscal year and it was hopeful that would bring a settlement to the deal.  October came and went with no resolution.

November:  Still no resolution.  This time of year is when most healthcare plans enroll their members for the following calendar year.  Those who are able will probably sign up for an alternative plan to UHC.  For them, it won’t matter if UHC and BRRH finally agree – they’ll be committed to another provider for 2020.  Those who have no choices other than UHC are stuck with searching for new physicians and a new hospital.

So what caused the breakdown? 

 A person familiar with the negotiations says UHC has a variety of plans, some of which are profitable to BRRH, and some that are not.  The BRRH position is that they would accept the profitable plans but not the unprofitable ones.  The UHC position is essentially all or none, take it or leave it.  Surely there were many other complications.  So now we are at an impasse.

So where do the players stand now?

BRRH:  Will lose their UHC revenue from the policies that lapsed, not just revenue from the less profitable plans.  BRRH is in the best position to break the impasse but doesn’t choose to compromise.  At any rate, it’s too late for 2020 no matter what happens.

UHC:  Will lose (what to them) is a small number of subscribers.  Kind of like if you dropped a penny at the change counter and were too lazy to bend over and pick it up.

Physicians and Health Care Providers:  Find themselves referring their precious long-time patients to other physicians who have privileges elsewhere.  Or sending their patients to other hospitals.  It seems safe to say that they are not happy with having insurance companies running their business…..

And finally, the patients, who are the most affected of all:  It is the patients who literally live or die based on these decisions.  It is the patients who pay insurance premiums, copays, deductibles etc., and no one asked them to participate in the negotiations!  Healthcare may be the only business in the world where paying customers are routinely ignored, in this case by UHC and BRRH.  

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