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BayCare, United Healthcare reach deal

Pinellas Sheriff Bob Gualtieri dipped into a fund in the agency’s self-insurance plan to help employees cover higher costs created by the dispute.

JAMES BORCHUCK | Times (2012)

Pinellas Sheriff Bob Gualtieri dipped into a fund in the agency’s self-insurance plan to help employees cover higher costs created by the dispute.

The region's largest hospital system and one of its largest insurers on Friday ended the bitter stalemate that for almost two months had nearly a half-million Tampa Bay area residents scrambling over their health care options.

BayCare Health System and United Healthcare said in a joint statement that they had signed off on a new five-year contract, renewing in-network access to BayCare's 10 hospitals, ancillary facilities and nearly 400 hospital-employed physicians.

The agreement covers people participating in any UnitedHealthcare medical plans, including Medicare, Medicaid, Florida Healthy Kids, individual and employer-sponsored programs.

In addition, UnitedHealthcare members who received care at BayCare facilities on or after Nov. 26, 2012, will be considered in-network.

In a phone interview Friday evening, BayCare president and CEO Steve Mason declined to comment on any potential rate increases or other financial details of the agreement, citing confidentiality and competitive pressures in the marketplace.

"We were looking for a fair, equitable agreement," Mason said. "It's a very complex agreement with a lot of parts in it and when you add it all up it put us, we think, in a fair position. It put United in a fair position and kept health care affordable for the community."

The agreement's five-year term, he said, means patients won't face similar uncertainty anytime soon.

"We're relieved, like I believe the community is, and we're ready to go back to work and focus on what's really important to us — and that's taking care of patients,'' Mason said.

"Our renewed network relationship gives all UnitedHealthcare plan participants access to quality medical facilities and skilled physicians close to where they live and work," said David Lewis, UnitedHealthcare's CEO for north and central Florida, in a news release.

But neither side would disclose terms of the agreement or what it might mean for rates.

The contract fight drew attention from the area's top elected officials, since many public employees are insured through United. Pinellas Sheriff Bob Gualtieri said Friday evening that Mason called him with the news of the settlement but offered no details on rates.

"I told him it's fantastic news," Gualtieri said. "Of course, I look more to finding out more of the details so we know what to expect."

It was a hard two months for employees, said the sheriff, who was spending up to $500,000 a month to help people meet added health costs created by the dispute. The money comes from a trust fund in the agency's self-insurance plan.

"They were facing much higher out-of-pocket" costs, he said. "It's a big deal for everyone, and I am glad to see they were able to come to terms."

The fight between the two health care giants led to a remarkable public airing of medical prices and who really foots the bill for health care. Both sides traded public accusations — aired in full-page newspaper ads — of unreasonable pricing and payment policies. United accused BayCare of using its market dominance to win unreasonable rates. It said BayCare was requesting as much as a 22 percent increase for employer plans, which translated to these whopping hikes:

• Hip replacement surgery would increase by $12,000.

• Breast biopsy would increase by $5,500.

• Cardiac catheterizations would increase by up to $5,000.

BayCare called the figures misleading and a violation of their confidentiality agreements. But in earlier letters to Medicare Advantage patients, BayCare said UnitedHealthcare owed it $11 million in unpaid claims and refused to pay "fair" reimbursement rates.

During the fall Medicare enrollment period, BayCare encouraged seniors to pick other plans, saying United Medicare Advantage patients would no longer be able to use popular facilities such as St. Anthony's, St. Joseph's, Morton Plant and Mease hospitals — for anything but emergency care after Nov. 26.

The dispute between the insurer and hospital system dated to May when negotiations over several lines of business, including Medicare Advantage and employer group accounts, fell apart. The last contracts expired in November.

Some saw the United-BayCare fight as a sign of the times, as escalating health care costs prompt insurers and employers to take a harder line.

But in the end, both sides may have lost favor with the patients they serve.

George Bodie, 76, who has on United Medicare plans, has been getting his routine blood work done at Florida Hospital North Pinellas in Tarpon Springs after his usual BayCare facility, Mease Dunedin Hospital, stopped taking his plan.

His wife, Barbara, 73, has several tests due in March, including a mammogram and ultrasound.

The Palm Harbor woman was thrilled to hear of the agreement Friday evening.

"Oh my gosh, I've got goosebumps all over me,'' she said, relieved to learn she and her husband can stick with their familiar providers. "That was our major concern," she said.

But the couple wasn't tempted to drop their insurer.

"We stayed with United thinking there are so many people affected by this that they will surely come to some sort of agreement soon," she said.

Others were taking no chances.

Carol White, a 69-year-old St. Petersburg resident, switched to a Florida Blue Medicare Advantage plan rather than risk losing her doctor at BayCare's Suncoast Medical Clinic.

"I wanted to keep my doctor. Had it not been for that I might have stayed" with United, she said.

Bert Saile, a 78-year-old New Port Richey resident, also dropped United for Florida Blue.

"We wanted to keep the same doctors," he said. "I think we're happy with what we have."

Jodie Tillman can be reached at jtillman@tampabay.com. Letitia Stein can be reached at lstein@tampabay.com.

BayCare, United Healthcare reach deal 01/18/13 [Last modified: Friday, January 18, 2013 11:33pm]
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