Updated August 28, 2024
The University of Florida Health (UF Health) is demanding a more than 25% price hike in just the first year of our commercial contract and is refusing to finalize the terms we’ve agreed to for our Medicaid plan
For the past several months we’ve made numerous efforts to try to move our negotiation forward with UF Health. Unfortunately, little progress has been made due to the health system’s repeated demands for a more than 25% price hike in just the first year of our contract.
UF Health is also refusing to finalize the agreed-upon terms for our Medicaid plan. This would have ensured continued, uninterrupted access to UF Health’s hospitals, facilities and physicians for our UnitedHealthcare Community Plan members while we continued efforts to renew our commercial relationship.
It has always been our goal to reach an agreement that is affordable and ensures continued network access to UF Health. Unfortunately, the health system has made that outcome unrealistic to date.
While we remain committed to continued good-faith negotiation, we can only assume UF Health’s intentions are to leave our network given their continued demands for outlandish rate increases that aren’t acceptable or affordable for the people we collectively serve.
If we are unable to reach an agreement, UF Health will be out of network for our employer-sponsored commercial plans, including UMR, as well as our Student Resources plan and Medicaid plans, effective Sept. 1, 2024.
Please note UF Health’s psychiatric hospital and UF Health Central Florida are on a separate contract and are not impacted by our negotiation. They continue to remain in our network.
Important note for people enrolled in our Medicare Advantage plans: Only UF Health St. John’s – Flagler Hospital and its physicians would be out of network for our Medicare Advantage plans if we are unable to reach an agreement prior to Sept. 1
This negotiation does not impact Medicare Advantage plans or our Dual Special Needs Plans (DSNP) at other UF Health hospitals and professional provider locations throughout the state, such as but not limited to: UF Health Gainesville, Jacksonville, Leesburg or The Villages Regional Hospital. They continue to remain in-network with UnitedHealthcare for our Medicare Advantage plans, regardless of the negotiation outcome.
UF Health is putting some of Florida’s most vulnerable residents in the middle of this negotiation, potentially creating unnecessary and completely avoidable disruption in access to care for our Medicaid members
We already have an agreement on rates and terms for our Medicaid plan and provided a proposal on multiple occasions to finalize a separate contract. This would have ensured continued, uninterrupted access to UF Health’s hospitals, facilities and physicians for our UnitedHealthcare Community Plan members while we continued efforts to renew our commercial relationship. UF Health has repeatedly rejected our proposals.
Nearly 70% of UF Health’s total price hike demands for our commercial plans would come out of the operating budgets of self-insured employers
UF Health’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. Nearly 70% of our commercial members throughout northern Florida are enrolled in self-insured plans.
Agreeing to UF Health’s rate demands would mean approximately 20 self-funded businesses would each see their health care costs go up by $200,000 or more in just one year. Three self-funded employers would see their costs increase by approximately $600,000 or more each, with one experiencing approximately $1.6 million in increased health care costs over the next 12 months.
This would mean these employers have less money available to help grow their business through things like investments in new technologies or increase salaries for employees.
UF Health’s proposal would significantly impact what consumers pay for services received at its hospitals
To help illustrate the impact of the health system’s more than 25% price hike demands in just one year, consider the following examples:
- The cost of a C-section would increase by more than $5,000 at Shands Jacksonville, while the same service would go up by more than $4,000 at Shands UF Gainesville.
- That means on average a person with a 20% co-insurance could expect to pay $1,000 more out of pocket than they do today for this service at Shands Jacksonville, and approximately $800 more at Shands UF Gainesville.
- The cost of a vaginal delivery would increase by approximately $3,600 at Shands Jacksonville and by $3,100 at Shands Gainesville.
- The insertion of a permanent pacemaker would increase by approximately $12,000 at Shands Gainesville.
It remains our goal to reach an agreement that is affordable for the people we serve while ensuring continued access to the health system. However, we need UF Health to share our commitment and work toward realistic solutions Florida families and employers can afford.
Our goal is to keep UF Health’s hospitals and physicians in our network at market-competitive rates. We have made significant compromises and remain committed to continued good-faith negotiation with the goal of renewing our relationship at rates that are affordable for Florida families and local employers.
We have created the following FAQs to ensure you and your family have the information needed regarding next steps as well as details to help meet your health care needs:
FAQs
Our goal is to renew our relationship without any disruption while helping ensure health care remains affordable for you, your family and the employers we serve throughout Florida. However, if we are unable to reach an agreement, the majority of UF Health’s hospitals, facilities and its physicians will be out of network for employer-sponsored commercial plans, including UMR, as well as our Medicaid plans and our Student Resources plan, effective Sept. 1, 2024.
UF Health’s psychiatric hospital is on a separate contract and is not impacted. It will remain in our network regardless of the outcome of our negotiation. UF Health Central Florida is not impacted and will also remain in our network.
Only UF Health St. John’s – Flagler Hospital and its physicians would be out of network for our Medicare Advantage plans and Dual Special Needs Plan (DSNP) if we are unable to reach an agreement prior to Sept. 1. UF Health’s other hospitals and physician practices would continue to participate in our Medicare Advantage network, regardless of the outcome of our negotiation.
This negotiation impacts people enrolled in employer-sponsored commercial plans, including UMR, as well as our Medicaid plans and Student Resources plan.
Only UF Health St. John’s – Flagler Hospital and its physicians would be out of network for our Medicare Advantage plans, including our Dual Special Needs Plan (DSNP). The remaining UF Health hospitals and physicians would continue to participate in our Medicare Advantage network, including DSNP, regardless of the outcome of our negotiation.
Only UF Health St. John’s – Flagler Hospital and its physicians would be out of network for our Medicare Advantage plans if we are unable to reach an agreement prior to Sept. 1.
This does not impact Medicare Advantage plans or our Dual Special Needs Plans (DSNP) at other UF Health hospitals and provider locations throughout the state. Some examples of UF hospitals that will continue to participate in our Medicare Advantage network beyond Sept. 1 include but are not limited to:
- UF Health Gainesville
- UF Health Jacksonville
- UF Health Leesburg
Yes. Our goal is to reach an agreement that avoids any disruption to you and your family. We are committed to continued good-faith negotiation in an effort to reach a long-term agreement that is affordable for you, your family and local employers.
Our top priority is ensuring you and your family have access to the care you need. Please know you will continue to have access to thousands of physicians and a robust network of hospitals in your area, should UF Health leave our network. Some examples of hospitals remaining in our network in the impacted areas include but are not limited to:
- AdventHealth Palm Coast
- AdventHealth Palm Coast Parkway
- Ascension St. Vincents Riverside
- Ascension St. Vincents Southside
- Baptist Medical Center
- Baptist Medical Center-Beaches
- Baptist Medical Center-Nassau
- HCA Florida Memorial Hospital
- HCA Florida North Florida Hospital
- HCA Florida Orange Park Hospital
- Mayo Clinic Florida
- Wolfson Children’s Hospital
For assistance finding an alternative hospital or physician in your area, please call the number on your health plan ID card. You can also use the provider directory on our member website – www.myuhc.com to search for alternative hospitals and doctors.
If you or someone in your family is in the middle of treatment at a UF Health hospital, facility or with a UF Health physician and they go out of network, you may qualify for continuity of care. Continuity of care provides continued in-network benefits for a specified period of time after a provider leaves our network. A few examples of patients who may qualify include:
- Women who are pregnant
- Patients with newly diagnosed or relapsed cancer, or those currently in active cancer treatment.
It’s important to note you and your doctor can apply for continuity of care at any point prior to our contract potentially ending with UF Health. Should UF Health leave our network, you have an additional 30 days following the date they went out of network to apply for continuity of care. For example, if UF Health goes out of network on Sept. 1, you have through Sept. 30 to apply.
If you or someone in your family has questions about continuity of care, please call the number on your health plan ID card.
Your prescription drugs would still be covered so long as you receive them from an in-network pharmacy, regardless of whether the prescribing physician participates in our network or not. If you need assistance finding an in-network pharmacy in your area, please call the number on your health plan ID card.
In the event UF Health leaves our network, people enrolled in our Group Retiree PPO plan may still receive care from a UF Health physician or facility as an out-of-network provider, if they are a Medicare-approved provider that accepts the plan. Your 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.
In the event of an emergency, UnitedHealthcare members should always go to the nearest hospital. Their services will be covered at the in-network benefit level, regardless of whether the hospital participates in UnitedHealthcare’s network.