Saint Joseph Patients Face Higher Costs Amid Reimbursement Rate Dispute with Insurer

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SOUTH BEND, Ind. – Patients of Saint Joseph Health System who are insured by UnitedHealthcare are now facing significantly higher costs due to a failure to reach a new contract agreement. As of July 1, Saint Joseph Health System’s services are no longer considered “in-network” for UnitedHealthcare policyholders, affecting more than 6,000 patient households.

The dispute stems from prolonged negotiations between Saint Joseph Health System and UnitedHealthcare, the nation’s fourth-largest health insurer. Chris Karem, president of Saint Joseph Health System, stated that the nonprofit Catholic health system had been in talks with UnitedHealthcare for eight months before the deadline was missed last week.

"At one point, they even asked us to accept payment reductions," Karem said. "So as you can imagine, everybody listening and all of us have experienced a significant rise in the cost of everything, and they wanted us to go backward. Their parent company, United Health Group, earned $22 billion in profits last year. I can't even put my mind around that kind of a number."

UnitedHealthcare declined an interview request but provided a written statement, arguing that Saint Joseph Health System had demanded “price hikes that are not affordable or sustainable for the people and employers we serve throughout Indiana. We compromised and proposed meaningful rate increases that would have ensured Saint Joseph Health continued to be reimbursed at market-competitive rates.”

This development means patients will have to bear the brunt of out-of-network charges, which are substantially higher than in-network rates. However, patients already undergoing treatment for chronic conditions such as cancer can petition UnitedHealthcare to continue receiving in-network rates.

The breakdown in negotiations highlights the broader issue of rising healthcare costs and the complexities of insurer-provider agreements, leaving patients caught in the crossfire and facing financial strain.