Bon Secours and UnitedHealthcare are locked in a contract dispute that could jeopardize the healthcare of about 30,000 patients statewide.
By failing to sign a new contract, UnitedHealthcare members could see increased out-of-pocket costs and more out-of-network visits. The two sides are looking to resolve the dispute over reimbursement rates before the contract expires on July 1, according to Bon Secours.
“We’ve made repeated efforts to secure a fair agreement that reflects today’s health care environment, but United continues to underpay compared to market standards,” said Matt Caldwell, president of Bon Secours Greenville, on May 12.
“Our priority is to reach an agreement that reflects the current healthcare environment and ensures we can continue providing the high-quality care our patients expect and deserve.”
The negotiations, which began in January, may impact all Bon Secours providers and facilities in South Carolina if an agreement can not be reached before the July deadline. Members with Commercial, Medicare Advantage, Exchange, and the Veterans Affairs Community Care Network insurance plans also would risk losing UnitedHealthcare coverage.
The two sides remain far apart, according to Bon Secours.
A look inside the new Bon Secours St. Francis Downtown Hospital emergency room Monday, Nov. 15, 2021. The new 45,000 square foot emergency department will open Nov. 30.
UnitedHealthcare and Prisma Health faced similar dispute a year ago
After failing to reach an agreement in January 2024, about 58,000 South Carolina patients were left out of the network with Prisma Health, the largest healthcare organization in the state.
At the time, the healthcare companies blamed each other for the dispute, with UHC claiming Prisma requested a nearly 20% price hike, and that the insurance company delivered nine proposals.
By the end of July 2024, UnitedHealthcare and Prisma Health reached a multi-year contract allowing UHC patients back in network with the hospital system. The agreement was retroactive to June 1, 2024. UHC patients who saw Prisma physicians in June were billed in-network, while patients who saw Prisma’s doctors before the June date were billed out-of-network.
What did UnitedHealthcare say about the Bon Secours negotiations?
On May 20, UnitedHealthcare released a statement saying that Bon Secours was seeking a price hike of nearly 32% over three years, which would drive up costs by $43 million over three years.
The figures are based on United Healthcare’s commercial plans, which estimate inpatient surgery costs increase by $11,000 and an emergency room visit by more than $700 per visit if UHC were to agree to the terms.
“We are in active negotiation with Bon Secours St. Francis in South Carolina,” UHC officials wrote in the online statement. “Our top priority is to reach an agreement that is affordable for consumers and employers while ensuring continued network access to the health system.”
– A.J. Jackson covers business, the food & dining scene and downtown culture for The Greenville News. Contact him by email at ajackson@gannett.com, and follow him on X (formally Twitter) @ajhappened. This coverage is only possible with support from our readers. Sign up today for a digital subscription.
This article originally appeared on Greenville News: Bon Secours, UnitedHealthcare dispute could cut 30,000 from network
