United HealthCare, CT hospital system reach 11th hour agreement

Hartford Courant – Tuesday, April 1, 2025
By Don Stacom

As two giants in Connecticut’s health care industry approached a deadline Monday night that could jeopardize health care benefits for thousands of people, state Healthcare Advocate Kathleen Holt said consumers and patients are suffering no matter how the dispute resolves.

“I think both sides leverage the fright they create. They’ve caused a lot of sleepless nights for people, and in the end they’ll both say ‘people should be grateful. Nothing to see here, just forget about it,’ ” Holt said.

“This keeps happening again and again and again. People are paying good money for health care and being put through this. We need to find a way to stop it,” Holt said.

Then Hartford HealthCare and UnitedHealthcare reported early Tuesday that they finished negotiating in the final hours before a payment dispute that put thousands of Connecticut residents into uncertainty about their health care benefits.

Their contract was to expire at midnight, a prospect that would immediately limit where United’s Medicare Advantage customers could get in-network hospital care.

“Hartford HealthCare and United Healthcare have reached an agreement that will ensure that United Healthcare members continue to have uninterrupted access to Hartford HealthCare’s physicians, hospitals and service,” according to a Hartford HealthCare spokesperson. “This is good news for our patients and communities, and allows us to continue our mission to improve the health and healing of all.”

Connecticut’s 60-day cooling-offer period protects other United customers by requiring the company to provide them with in-network coverage for Hartford HealthCare’s hospitals through May 31. But that wouldn’t have coverd assisted living centers, surgical centers, Hunter’s Ambulance, United said.

“In the event our contract with HHC ends on April 1, any non-emergent services received at an HHC hospital, facility or physician would be considered out of network for Medicare Advantage and DSNP members, unless they were approved for continuity of care,” United said earlier Monday.

Valid emergency room visits are covered by the in-network rate regardless of the contract.

Holt’s office has developed a fact sheet to explain exactly what is and isn’t covered if the contract ends; Hartford HealthCare has its own version, as does UnitedHealthcare.

At issue was how much United will pay Hartford HealthCare for procedures and services billed from April 1 forward. Hartford HealthCare contends it is only seeking to keep up with cost increases, and that United’s offers are so low that they’d impede its ability to keep clinical staff. United contends the hospital conglomerate wants too much.

In the middle were the unknown number of United’s 600,000 Connecticut customers who use Hartford HealthCare’s huge network of hospitals, specialists, urgent care clinics and other services. Depending on specific policies, patients who for years have used Hartford’s services with in-network coverage rates would begin getting coverage at out-of-network rates after May 31.

United notified customers 30 days ago that the contract was still unresolved and would expire March 31.

“We got a slew of calls then from people who wanted answers. Now that it’s back on their doorstep, people are calling again because they realize it’s been quiet,” Holt said.

Trinity Health of New England went through the same type of dispute with United in Connecticut last summer, and numerous other states have reported similar conflicts between large hospital networks and insurers. The University of Connecticut’s health care system is facing an April 15 deadline with an insurer, Holt noted.

“It’s a cycle that doesn’t stop. And people who’ve been going to the same doctor for 30 or 40 years end up saying ‘What do you mean I’m can’t go anymore?,’” she said.

While both sides fought over finances, patients are left with uncertainty and anxiety, Holt said.

“If you have a procedure that’s $2,000, you’re responsible for your deductible and coinsurance. But if there’s no contract, you’d have less coverage or no coverage so you might get billed $15,000,” she said. “That same procedure can be 750% more out of network.”

Holt noted that negotiations are all conducted out of view of the public, with no detailed explanations afterward.

“You know the saying that if you’re not at the table you’re on the menu. That’s what this feels like,” she said. “They create carnage in their wake, the feeling of goodwill to the hospitals and the health care system is just eroding. And in the end, the hospital will say ‘We didn’t get enough, we can’t provide as much as we did’ and the insurance company will say ‘We have to raise our rates’.”

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