Some metro-area hospital patients can expect longer waits for surgeries and fewer hospital choices given that a contract-renewal deadline has expired between hospital operator HCA Inc. and insurer United Healthcare, industry experts said Thursday.
Gov. Bill Owens on Thursday discussed the impasse with the Colorado chief executives of both organizations, urging them to continue to negotiate and work toward a resolution, an Owens spokesman said.
U.S. Sen. Ken Salazar, D-Colo., sent a letter Thursday to HCA and United executives, saying: “The consequences of failing to reach a contractual agreement endangers the health of over 850,000 Coloradans insured by United Healthcare, who could potentially be left without health care providers.”
The contract-renewal deadline passed Thursday.
HCA and United say they have reached an impasse over proposed increases for reimbursement rates, which are paid by insurance companies to hospitals for patient care. Both companies are open to further meetings, although none is scheduled.
The impasse means HCA hospitals are now considered “out of network” for Colorado residents insured through United and its affiliates, PacifiCare and SecureHorizons. About 30,000 of those members received treatment at HCA facilities within the last year, said Tyler Mason, a United spokesman.
“There’s going to be disruptions” for patients, said Linda Kanamine, a spokeswoman for HCA, the Nashville, Tenn.- based hospital group that co- owns and operates seven metro-area hospitals under the name HealthOne.
Minneapolis-based United, Colorado’s largest health insurer, counters that some of its members had already scheduled and received treatment in advance of the contract-renewal deadline.
“It’s not going to be like flipping on a big light switch for everybody,” Mason said.
United members could be forced to pick new hospitals or pay a larger percentage of the cost of care to continue receiving treatment at HCA facilities.
Depending on the plan, insurance companies typically cover 75 percent or more of the bill when patients are treated at in- network hospitals. For out-of- network hospitals, insurance companies often pay 50 percent or less of the bill.
Emergency services at HCA facilities would still be covered. Also covered under “continuity of care benefits” would be “qualifying acute conditions.”
Patients and employers covered by United may now consider switching insurance companies and seek treatment at other metro-area hospitals, which could strain those facilities during the next few weeks, said Jim Hertel, publisher of Colorado Managed Care newsletter.
Jeff Selberg, president and chief executive of Exempla Healthcare, a Denver nonprofit that operates three metro- area hospitals, said “a couple hundred” physicians had requested admitting privileges for Exempla facilities.
But he added that depending on the week, his hospitals are nearly full or have space for an additional 50 or so patients.
The state’s two largest nonprofit hospital operators, Centura Health and Exempla, are still covered by United.
Staff writer Will Shanley can be reached at 303-954-1260 or wshanley@denverpost.com.
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