It’s no secret that healthcare is incredibly complex. While we wish the complexities only existed around our expert physicians thoughtfully diagnosing and caring for our patients, there is a whole other layer of complexity when it comes to the complicated world of health insurance coverage and health plan networks.
These complexities are magnified when UnitedHealthcare — the nation’s largest and, according to the most recent quarterly earnings statements, most profitable health insurance company — forces a local hospital system and physicians’ group like Piedmont out of its network.
“Out of network” is a phrase no one uttered 20 years ago. But today’s unfortunate reality is that consumers and employers alike are now burdened with worrying about their healthcare choices and the impact those choices may have on their family finances, their company’s bottom line and their access to the highest quality care.
United’s decision to remove Piedmont facilities and Piedmont Clinic physicians from its network — five hospitals and 1,400 physicians in total — forces employers and consumers to deal with the added burden of evaluating new health insurance options. Hundreds of thousands of Georgia residents now have to choose between their trusted healthcare provider and the United insurance card in their wallet.
When our physicians take their oath, they make a commitment to doing whatever it takes to care for the sick, to treat our patients as people and not numbers or diseases, and to remember that we are obligated to the betterment of society and people as a whole. These are the values Piedmont adheres to each and every day.
But health insurance companies – obligated to shareholders first and their members second – clearly don’t hold these same values. It’s why issues with insurance companies are so disheartening and why companies like UnitedHealthcare dictate healthcare decisions of patients and entire communities rather than paying for the sound healthcare decisions made by their members and their trusted physicians.
It’s also why everyone with a United commercial insurance health plan, whether covered through an employer or a plan they purchased themselves, should be alarmed about Piedmont being forced out of United’s network.
Having one hospital or physician group being forced out is cause for concern, but it’s an even greater deal when five hospitals and 1,400 physicians across greater Atlanta — the very hospitals and physicians our community trusts — disappear overnight from any insurance company’s network.
Even beyond United members, this disruption to healthcare impacts the entire community. Dealing with these kinds of issues distracts physicians and hospitals from caring for patients and creates significant financial stress, producing a ripple effect on the entire healthcare system. Local business owners and employers must invest precious time and resources in helping their employees navigate the choices and potential impacts, as well as help them find a new insurance provider. Ultimately, this situation creates more work and undue burden for everyone except United.
It can be tempting to throw up your hands in frustration and helplessness. It can also be tempting to hope for a last-minute deal to avoid having to do anything about this issue. Yet, as your trusted, local healthcare provider, we’re here to help and offer some important facts about why it’s important to take action now:
· Following United’s original request that our physicians take a 12 percent reduction in pay, negotiations have produced no meaningful compromise or results, and United’s negotiating position has gone backward in the last month. We value the caliber of our physicians and the quality of care they provide every day. Apparently, United does not share this value and is attempting to disrupt the patient physician relationship.
· We are out of network across five of our hospitals with a sixth, Piedmont Newton, also slated to go out-of-network on Jan. 31, 2017. Our focus now is planning for a future across all hospitals and physicians without United.
· Time has run out and patients must now make a critical choice. Switch insurance to remain in-network with the trusted Piedmont physicians and hospitals that manage your care, or remain with United and pay more of your hard-earned money to get care at Piedmont. We are in network with other major insurers in Georgia and they are all ready to assist in helping patients get access to the care they need and deserve.
As stewards of our patients and our community, we empathize with the difficulty this poses and we wish it weren’t happening. Yet, despite Piedmont making every effort to resolve this issue, United has made clear that they don’t share our values and priorities — or yours.
We encourage all United commercial health insurance members to consider the impacts of UnitedHealthcare’s actions on your health and the health of your community and to take the step of switching to insurance coverage that includes Piedmont. It is our goal to ensure every patient is protected and cared for without interference from a for-profit insurance company.
President and CEO