Sunday, May 27, 2018
Health

Tampa Bay employers seek to help workers caught in BayCare-UnitedHealth dispute

Pinellas Sheriff Bob Gualtieri has been thinking about paying a bigger share of his employees' medical bills. But don't pin the move on his holiday spirit.

Like other local employers that offer United Healthcare insurance plans, Gualtieri is looking for ways to soften the impact of the insurer's stand-off with BayCare Health System. That fight has left hundreds of thousands of Tampa Bay residents facing high out-of network rates if they use BayCare hospitals and doctors.

Gualtieri said his office, for instance, may subsidize the additional costs to employees for up to three months. He estimates that short-term subsidy would cost about $400,000 a month.

Pinellas County government, another UnitedHealth member, will pay half of its employees' costs for out-of-network rates through the end of this month.

In Hillsborough, the tax collector's office and the city of Tampa are among those feeling the fallout, as are private employers who use United.

Bishop Robert Lynch of the Diocese of St. Petersburg has even blogged on the situation.

"I cannot envision being a part of a health care plan which does not include St. Anthony's and St. Joseph's Hospitals, but BayCare is demanding a dramatic increase in reimbursement fees which will also impact the already stretched and tight budgets of our parishes, schools and institutions," he wrote last month while waiting in an airport.

"We've had a lot of anxiety," said Peggy Rowe, Pinellas County's director of human resources. She said every $1 that an insured worker spends on out-of-network care costs the county $4.

St. Petersburg Mayor Bill Foster said he may reopen enrollment to allow employees to convert to a preferred provider organization, which requires higher premiums but includes out-of-network benefits. The city covers a total of nearly 6,800 people — counting employees, dependents and retirees — in its plan.

As is the case with the Pinellas Sheriff's Office and Pinellas County, the city of St. Petersburg is self-insured, with United acting as its third-party benefits administrator.

Foster said he's holding off on any changes.

"I remain optimistic that both parties will reach an agreement before Christmas," he said, declining to elaborate.

BayCare and United officials said this week they are no closer to a deal. Contract talks between the two companies ended late last month without an agreement. The resulting showdown has left nearly half a million people in the bay area, including many on United Medicare Advantage plans, with only limited access to BayCare hospitals.

BayCare, which accuses United of owing $11 million in unpaid claims, says it is requesting a "fair" increase in reimbursement rates from the insurer. United says BayCare's rate requests are too high and will only increase the burden on patients.

Some employers are considering switching insurance companies next year — not necessarily because they're siding with BayCare but because the hospital system is the largest in the bay area and so many employees rely on it.

"Both entities have sent out a lot of information, and a lot of it's very self serving. The truth is somewhere in the middle," said Gualtieri.

He added that taxpayers will ultimately help pick up the tab for his office's share of potential out-of-network costs, estimated to be around $2 million. At budget season, he said, the Sheriff's Office will have to decide whether to make up the difference with only tax revenue or a mix of taxes and higher premiums and costs for employees and retirees.

Many employees simply can't switch immediately to another health care provider, especially in North Pinellas where BayCare's Morton Plant-Mease system is so dominant.

"I think they need to realize they're dealing with people's lives here," he said of BayCare and United.

Hillsborough Tax Collector Doug Belden said his nearly 300 employees, whose salaries average $35,000, have numerous alternatives to BayCare hospitals. But many of them have primary care doctors through BayCare's Health Point Medical Group.

Belden said he may consider opening the office to another insurance carrier next year.

"The least they can do is at least have a dialogue," Belden said of United and BayCare. "To me that's very irresponsible and could have a profound effect on their branding and reputation."

Foster said changing carriers could make things worse if the new insurer is expensive or doesn't include certain doctors or hospitals in their networks.

"You're never going to make everybody happy," he said.

As for BayCare, he said, "they could also price themselves out of the market."

Clearwater's Tech Data Corp. is siding with its insurer in the dispute.

"We support United Healthcare's efforts as stewards of our company's and our employees' health care dollars in attempting to maintain costs," Caryl Lucarelli, the company's vice president of human resources, said in a statement. "BayCare's withdrawal from the network creates a hardship, not only to our employees, but to the workforces of many other employers and Medicare recipients. We hope for an amicable and mutually beneficial settlement, quickly."

The St. Petersburg diocese insures 2,500 people through United, said spokesman Frank Murphy. It already has helped out several employees who couldn't afford their out-of-network share.

Murphy called the dispute "a real struggle," and he should know: He's a retired chief executive officer for BayCare.

Times writer Letitia Stein contributed to this report. Jodie Tillman can be reached at [email protected] or (813) 226-3374.

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