Updated July 1, 2024
Trinity Health of New England ends contract with UnitedHealthcare
Despite our repeated efforts to compromise, we were unable to renew our contract with Trinity Health of New England (THNE) following the health system’s decision to issue a notice to end our relationship. As a result, THNE’s physicians are now out of network for the following benefit plans, as of July 1, 2024:
- Employer-sponsored commercial plans, including both fully insured and ASO, as well as the Oxford Health Plan
- Medicare Advantage plans, including Group Retiree
- Medicaid plans, including our Dual Special Needs Plan (DSNP)
THNE’s hospitals are now out of network for the following benefit plans, as of July 1:
- Medicare Advantage plans, including Group Retiree
- Medicaid plans, including our Dual Special Needs Plan (DSNP)
Important note for people enrolled in fully insured and ASO commercial plans: fully insured commercial members, including Oxford, continue to have network access to all of THNE’s hospitals – including Mercy Medical Center in Massachusetts – through Aug. 31, 2024, in accordance with Connecticut cooling off requirements. As part of our effort to minimize disruption for the people we serve, we have agreed to apply cooling off for people enrolled in our ASO employer-sponsored commercial plans, including Oxford, ensuring continued network access to all of THNE’s hospitals through Aug. 31, 2024.
Our goal has always been to reach an agreement that is affordable for Connecticut and Massachusetts residents and employers while avoiding any disruption to care for our members. We compromised and proposed meaningful rate increases that would have ensured THNE continued to be reimbursed at market-competitive rates.
Unfortunately, THNE, which issued a notice earlier this year to end our contract as of July 1, maintained its demands for a more than 30% price hike that would take effect over the next 24 months. THNE’s proposal would have increased health care costs by more than $30 million and was not affordable or sustainable for the families and employers we serve. THNE’s rate demands were also more than double the annual cost growth benchmarks set by the Connecticut Office of Health Strategy (OHS).
We remain committed to continued discussions with THNE should the health system provide a realistic proposal consumers and companies can afford. However, our top priority at this time is ensuring the people we serve have access to the care they need through either continuity of care or a smooth transition to a new provider.
UnitedHealthcare members who need assistance finding a new provider or have questions about continuity of care can call us at the number on their health plan ID card. We have also created the following page to provide additional information regarding alternate providers remaining in our network in the area as well as details regarding continuity of care.
THNE is demanding a more than 30% price hike for our employer-sponsored commercial plans that would take effect over the next 24 months
Since the onset of our negotiation THNE has repeatedly made demands for outlandish rate increases that would significantly drive up health care costs for Connecticut and Massachusetts families and local businesses. THNE’s latest demands would increase health care costs by approximately $33 million for people enrolled in our employer-sponsored commercial plans.
Trinity Health’s commercial price hike demands are more than double the annual cost growth benchmarks set by the Connecticut Office of Health Strategy (OHS)
As part of the state’s effort to rein in health care costs, OHS established a healthcare cost growth benchmark target of 2.9% for 2024. OHS recently raised the benchmark to 4% for 2024 to account for inflationary trends.
Despite the raised benchmark target recently set by OHS, Trinity Health of New England is still seeking to increase its costs by more than twice the mark established by the state for 2024 and beyond, driving up health care costs for local residents and employers at a rate that is not sustainable.
Trinity Health of New England is also demanding special exceptions to our Medicare Advantage contract that no other health system in our Medicare Advantage network in Connecticut has
Agreeing to these language exceptions would drive up health care costs while having a direct impact on the benefits we’re able to offer to people who enroll in our Medicare Advantage plan.
Our goal is to keep THNE’s hospitals and physicians in our network at a cost that’s affordable for the people and employers we serve
We continue to compromise and are proposing meaningful rate increases that help ensure the health system continues to be fairly and appropriately reimbursed at market-competitive rates similar to their peers throughout the state.
A significant portion of THNE’s more than 30% proposed price hikes would come out of the operating budgets of self-insured employers if we agreed to their proposal
THNE’s rate demands would directly drive up health care costs for our self-insured customers given that these employers pay the cost of their employees’ medical bills themselves rather than relying on UnitedHealthcare to pay those claims. In Connecticut, more than 60% of our commercial members are enrolled in self-insured plans.
As the prices for health care continue to rise, employers have less money available to help grow their business through things like investments in new technologies or increase salaries for their employees.
In the event THNE leaves our network, people enrolled in our Group Retiree PPO plan may still receive care from a THNE physician or facility as an out-of-network provider, if they are a Medicare-approved provider that accepts the plan. Their share of the cost will be the same as if they were part of the network.
UnitedHealthcare Group Retiree members are encouraged to speak with their physician to confirm they’ll continue to see them, regardless of their network status.
For additional information about our Group Retiree plan as well as information on how to find a provider in their area, UnitedHealthcare members should go to retiree.uhc.com.
Our goal is to reach an agreement without any disruption to the families we serve. We continue to urge THNE to join us at the negotiating table with a reasonable proposal that’s affordable and sustainable for the residents and businesses we serve throughout Connecticut and Massachusetts.
We know the relationship our members have with their doctor is not only important; it’s personal. That is why our top priority is to renew our relationship with THNE so the people we serve have continued access to the facilities and physicians they know and trust for their health care needs. We are committed to meeting with the health system as often as it takes to reach a new agreement.
However, should THNE choose to leave our network, we have created the following page dedicated to information about continuity of care as well as alternative physicians and hospitals remaining in our network.