Skip to main content
Oregon Health & Science University and insurer UnitedHealthcare are making progress toward a new contract that will preserve coverage for 74,000 OHSU patients before the old one expires March 31.
The sides have reached a “good-faith agreement and are working to finalize new multiyear contracts,” an OHSU spokeswoman said.
Negotiating in “good faith” means to “deal honestly and fairly with one another so that each party will receive the benefits of your negotiated contract,” according to Harvard Law School’s Program on Negotiation.
A spokeswoman for UnitedHealthcare, the nation’s largest health insurer, confirmed that talks were on track toward a new contract.
“We remain actively engaged in good-faith discussions with OHSU,” the spokeswoman said in an email. “It remains our top priority to reach an agreement prior to April 1 that is affordable for Oregon families and employers while ensuring continued, uninterrupted network access to OHSU’s hospitals and providers.”
The progress comes after months of rancor. On a dedicated website that’s still up, UnitedHealthcare says OHSU is asking for a 36% price increase for its commercial plans over two years, in addition to a 15% increase for Medicare Advantage plans. Together, those changes would raise health care costs in Oregon by $88 million, the insurer said.
As part of its campaign against OHSU’s demands, UnitedHealthcare called attention to a survey showing the hospital system’s poor performance.
In a report released by its board of directors in January, OHSU disclosed that it ranked 95th out of 116 academic medical centers in an annual study by Vizient, a health care consulting company.
UnitedHealthcare links to the report on its website, saying, “OHSU’s high costs continue to rise, despite experiencing a significant decline in quality and safety standards over the past year.”
OHSU fired back last month, saying that UnitedHealthcare has a 56.4% denial rate, compared with the industry standard of 5% to 10%. It takes UnitedHealthcare an average of 307.3 days to resolve claims, the longest of all of the insurers OHSU does business with.
UnitedHealthcare called those claims “false.”
The March 31 deadline for a deal comes as OHSU tries to boost revenue to cover costs for wages and supplies that rocketed during the pandemic and remain stubbornly high. OHSU is waiting for regulators to approve its purchase of Legacy Health, which faces similar struggles.
Such battles are becoming common in the health care industry. Aetna dropped Providence Health & Services from its network Dec. 31 after months of negotiations came to naught.
Last month, the Wall Street Journal reported that the U.S. Department of Justice was investigating the way UnitedHealthcare bills Medicare. The DOJ is looking into whether the insurer records diagnoses that bring larger payments to its Medicare Advantage plans, the Journal reported, citing people familiar with the investigation.
At the time, UnitedHealthcare said it was unaware of any probe.