Patients forced to scramble
Boca Raton Regional ends contract with UnitedHealthcare after sides fail to reach agreement
Boca Raton Regional Hospital has ended its contract with UnitedHealthcare, leaving about 17,500 patients scrambling to find another health facility or go out of network.
Boca Regional, part of the Baptist Health system as of July 1, has been in negotiations with UnitedHealthcare, the nation’s largest health insurer, for the last month regarding a replacement agreement to its contract with the insurer, which expired June 30.
Boca Regional now has a new CEO, Lincoln S. Mendez, after the retirement of Jerry Fedele and has been aggressively trying to strike a more lucrative deal. Mendez had been chief executive officer at South Miami Hospital, also part of Baptist Health. A spokesperson for Baptist Health said the negotiation between Boca
Raton Regional and UnitedHealthcare has nothing to do with Baptist Health taking over the hospital.
“Given United’s unwillingness to reimburse Boca Raton Regional Hospital at market competitive rates, a new agreement has not been reached,” Tom Chakurda, a hospital spokesperson said Wednesday. “Boca Raton Regional Hospital would like to continue its participation with United under fair and reasonable terms.”
United Healthcare said it wants to serve Boca patients to have access to quality, affordable healthcare, but also wants a fair agreement with the hospital.
“We have offered Boca Raton Regional Hospital rate increases that compensate them fairly, but they are seeking significant rate increases of more than 15 percent in just one year, which is simply unsustainable for our employer group customers and the members we serve,” United Healthcare said in a written statement.
The contract with Boca Regional impacts United Healthcare members enrolled in employer-sponsored, individual, Medicare Advantage and Medicaid health plans. United said if it were to agree to the hospital’s demands, its self-funded customers would pay an additional $3.2 million in total health care costs over the next year for their employees’ care.
This week, patients with doctors affiliated with the hospital and scheduled procedures at Boca Regional complained they were informed of the situation and could no longer afford to be treated by their longtime doctors or get their needed medical tests.
UnitedHealthcare said members who have questions regarding continuity of care or alternative hospitals in their area should call the number on the back of their health plan ID card. Boca Raton Regional Hospital said it is contracted with all other major health plans in the area including Aetna, Cigna, Florida Blue and Humana.