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Wellstar, United Healthcare contract dispute leaves thousands without insurance options

Wellstar Douglas Hospital Wellstar Douglas Hospital in Douglasville ranked sixth in the nation among more than 3,000 U.S. hospitals measured by the Lown Institute for outcomes not only including medical and clinical ones but also equity, such as the ratio of pay for the lowest-ranking employees to the highest. The rankings were released July 2020. (PHOTO Courtesy of Wellstar Health System)

METRO ATLANTA — Thousands of metro Atlanta families will need to find new options for doctors and hospitals due to a contract dispute between Wellstar Health Systems and United Healthcare.

United’s contract for consumers expired with Wellstar this past weekend. The dispute does not impact United’s Medicare plan with Wellstar.

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Wellstar has 11 hospitals and hundreds of physicians and a variety of care and rehabilitation centers scattered throughout metro Atlanta. The company posted a letter to United Healthcare customers on its website. The website also has a very detailed list of what they will and won’t be able to do to assist those customers.

United says the stumbling block in negotiations is Wellstar asking for a 22% price hike.

Wellstar’s response was posted on their website.

“At Wellstar, our patients are at the center of everything we do. For several years, Wellstar has been working to renegotiate a contract with UnitedHealthcare that would result in reimbursements for Wellstar hospital and physician services similar to those from other health insurance providers. We understand how important it is to have full access to the local, high-quality providers and hospitals you know and trust, and we continue to work on reaching a new primary commercial agreement that prioritizes patient care”.

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United is encouraging their self-insured customers to look at other providers in metro Atlanta. Wellstar is telling their customers to ask their current doctors for referrals to other physicians as needed.

United said that patients in the middle of treatment for “serious conditions” would continue to be covered if they are being treated at Wellstar hospitals or by Wellstar doctors. The company cited examples such as women who are in the later stages of pregnancy and patients cancer diagnoses that need treatment.

Both sides say they are continuing negotiations and are optimistic an agreement can be reached in the near future.

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