UnitedHealthcare, Envision renew contract after ED billing dispute

UnitedHealthcare and physician staffing company Envision Healthcare have renewed their contract for 2019, resolving a dispute that threatened to leave patients on the hook for surprise out-of-network medical bills.

UnitedHealthcare and Envision butted heads for months over Envision's prices. UnitedHealthcare claimed that Nashville-based Envision, which staffs hospital emergency, radiology, anesthesiology and other departments, demanded excessive prices for its services and contributed to the high-cost of emergency department visits, in particular.

Envision claimed that UnitedHealthcare demanded "massive cuts" to allow its physicians to stay in network. Representatives for both companies declined to explain how the two overcame the dispute or what concessions were made.

Had the two companies not extended their contract, UnitedHealthcare members would have had to pay higher out-of-network charges when seeing an Envision physician, even if the physician worked at an in-network hospital. Patients often don't know they saw an out-of-network physician until they receive a big medical bill that their insurer won't cover.

Envision, which was sold to private equity firm Kohlberg Kravis Roberts, also dodged a potential hit to its bottom line. The company rakes in up to one-quarter—or $1 billion—of its annual commercial revenue from UnitedHealthcare alone.

"We are pleased to continue our long-term relationship with UnitedHealthcare by successfully extending our agreement to ensure patients have in-network access to Envision Healthcare hospital-based clinicians," Envision President and CEO Christopher Holden said in a statement. "We believe this is an opportunity for clinicians and payors to work together to make progress toward a more effective healthcare system."

UnitedHealthcare and Envision may have resolved their contract dispute, but surprise billing remains a widespread problem. Four in 10 insured adults reported they received a surprise medical bill in the last year, a Kaiser Family Foundation poll found in September.

On Monday, nine groups representing health insurers, employers and consumers on Monday called for Congress to protect patients from surprise medical bills from out-of-network providers. While some states have laws on the books to ensure citizens don't receive surprise bills, the federal government has yet to tackle the issue.