Updated Novermber 13, 2024
UF Health has provided its first proposal since allowing our contract to expire; continues to demand a more than 20% price hike in one year
More than two months have passed since the University of Florida Health (UF Health) allowed our contract to expire and left our network. It remains our priority to reach an agreement that is affordable for Floridians and employers and restores network access to UF Health.
Unfortunately, little progress has been made. While UF Health has publicly spoken about its urgency to reach an agreement, its actions behind the scenes illustrate otherwise.
It took UF Health 70 days to provide a counter to our last proposal, which included meaningful rate increases that would have ensured UF Health continued to be reimbursed at market-competitive rates.
UF Health’s latest proposal, which was received on Nov. 8, maintained its demands for a more than 20% price hike in the first year of our contract for our employer-sponsored commercial plans. In fact, UF Health’s proposal moved backwards in several areas. Algunos ejemplos incluyen lo siguiente:
- UF Health is now asking for an additional 10% rate increase for their physicians on top of what they previously proposed on Aug. 29
- The health system is demanding nearly 15% in additional price hikes on top of what they’d proposed in the past for people enrolled in our UMR plans
Rather than engaging in good-faith negotiation and collaborating on solutions that would put an end to this disruption, UF Health has spent the past few months spreading misinformation while leveraging our members to obtain outlandish rate increases that are not affordable for consumers or employers.
We understand you likely continue to have questions given the inaccurate information UF Health has repeatedly disseminated. We believe facts matter. We encourage you to go to www.uhc.com/ufhealth/facts, where you’ll find the truth regarding our negotiation.
We want to thank you again for your patience during this difficult negotiation. We know many people value having access to UF Health’s providers and are rightfully concerned an agreement has yet to be reached. Please know we remain committed to continued good-faith discussions. However, we need UF Health to join us at the negotiating table and to work toward solutions that are sustainable for Florida families and employers.
We believe quality care can also be affordable and the people of Florida deserve both.
University of Florida Health allows contract to expire; now out of network as of Sept. 1
The University of Florida Health (UF Health) is now out of network for people enrolled in the following plans, as of Sept. 1, 2024:
- Employer-sponsored commercial plans, including UMR
- The UF Student Health Insurance Plan through Student Resources
- Planes de Medicaid
UF Health’s psychiatric hospital and UF Health Central Florida are on a separate contract and are not impacted by our negotiation. They continue to remain in our network.
Only UF Health St. John’s – Flagler Hospital and its physicians are out of network for our Medicare Advantage plans as of Sept. 1
This negotiation does not impact Medicare Advantage plans or our Dual Special Needs Plans (DSNP) at other UF Health hospitals and professional provider locations throughout the state, such as but not limited to: UF Health Gainesville, Jacksonville, Leesburg or The Villages Regional Hospital. They continue to remain in-network with UnitedHealthcare for our Medicare Advantage plans on and after Sept. 1.
We delivered a contract on Aug. 31 to finalize the terms UF Health had indicated they’d accept for our Medicaid plan. The health system never responded, allowing our contract to expire
UF Health indicated on the morning of Aug. 31 a willingness to continue participation in our Medicaid network. We delivered a contract that provided the terms they sought. UF Health never responded, disrupting access to care for approximately 30,000 people enrolled in our Medicaid plan who rely on UF Health for their health care needs.
We delivered a proposal on Aug. 30 that included meaningful movement and additional rate increases on top of what we’d already proposed for our employer-sponsored commercial plans. UF Health never responded to our commercial proposal and walked away from the negotiation
UF Health’s last proposal was sent on Aug. 29 and included demands for a 30% price hike over two years, including a more than 20% rate increase in the first year of our contract. UF Health’s proposal was not affordable or sustainable for Floridians and employers.
As part of our continued efforts to compromise and negotiate in good faith, we delivered a counter to the health system on Aug. 30 that included additional rate increases on top of what we’d already proposed. All of our proposals ensured UF Health would be reimbursed at rates similar to their peers in the market. UF Health never responded to our last proposal and allowed our contract to expire.
Nearly 70% of UF Health’s total price hike demands for our commercial plans would come out of the operating budgets of self-insured employers
UF Health’s rate demands would directly drive up health care costs for our self-insured customers given that these employers pay the cost of their employees’ medical bills themselves rather than relying on UnitedHealthcare to pay those claims. Nearly 70% of our commercial members throughout northern Florida are enrolled in self-insured plans.
Agreeing to UF Health’s rate demands would mean nearly 20 self-funded businesses would each see their health care costs go up by $200,000 or more in just one year. Three self-funded employers would see their costs increase by $550,000 or more each, with one experiencing approximately $1.5 million in increased health care costs over the next 12 months.
This would mean these employers have less money available to help grow their business through things like investments in new technologies or increase salaries for employees.
UF Health’s proposal would significantly impact what consumers pay for services received at its hospitals
To help illustrate the impact of the health system’s more than 20% price hike demands in just one year, consider the following examples:
- The cost of a C-section would increase by more than $1,500 at Shands Jacksonville, while the same service would go up by more than $1,000 at Shands Gainesville.
- The insertion of a permanent pacemaker would increase by approximately $11,000 at Shands Gainesville.
- The cost of a Level 3-5 emergency room visit at Shands Jacksonville would increase by more than $550.
We provided UF Health a proposal that would ensure continued access to UF Health St. Johns – Flagler hospital, facilities and physicians for our Medicare Advantage plan.
Our proposal included the same terms and conditions we have in our existing contracts with all of UF Health’s other hospitals and providers that participate in our Medicare Advantage and DSNP network. UF Health refused to finalize the contract, unnecessarily disrupting access to care for our Medicare Advantage and DSNP members who rely on UF Health St. Johns – Flagler’s providers for their health care needs.
As a reminder, this negotiation does not impact Medicare Advantage plans or DSNP at other UF Health hospitals and professional provider locations throughout the state, such as but not limited to: UF Health Gainesville, Jacksonville, Leesburg or The Villages Regional Hospital. They continue to remain in-network with UnitedHealthcare for our Medicare Advantage plans on and after Sept. 1.
It remains our goal to reach an agreement that is affordable and restores network access to UF Health. However, we need UF Health to approach the negotiating table with a realistic proposal Floridians can afford and to finalize the terms of our Medicaid contract we’ve agreed to.
We have created the following FAQs to ensure you and your family have the information needed regarding next steps as well as details to help meet your health care needs:
Preguntas frecuentes
UF Health is now out of network as of Sept. 1, 2024 for people enrolled in the following plans:
- Employer-sponsored commercial plans, including UMR
- The UF Student Health Insurance Plan through Student Resources
- Planes de Medicaid
UF Health’s psychiatric hospital is on a separate contract and is not impacted. It remains in our network. UF Health Central Florida is not impacted and also remains in our network.
Only UF Health St. John’s – Flagler Hospital and its physicians are now out of network for our Medicare Advantage plans and Dual Special Needs Plan (DSNP). UF Health’s other hospitals and physician practices continue to participate in our Medicare Advantage network on and beyond Sept. 1.
This negotiation impacts people enrolled in employer-sponsored commercial plans, including UMR, as well as our Medicaid plans and the UF Student Health Insurance Plan through Student Resources.
Only UF Health St. John’s – Flagler Hospital and its physicians are out of network for our Medicare Advantage plans, including our Dual Special Needs Plan (DSNP). The remaining UF Health hospitals and physicians continue to participate in our Medicare Advantage network, including DSNP, on and beyond Sept. 1.
Only UF Health St. John’s – Flagler Hospital and its physicians are out of network for our Medicare Advantage plans, as of Sept. 1.
This does not impact Medicare Advantage plans or our Dual Special Needs Plans (DSNP) at other UF Health hospitals and provider locations throughout the state. Some examples of UF hospitals that will continue to participate in our Medicare Advantage network beyond Sept. 1 include but are not limited to:
- UF Health Gainesville
- UF Health Jacksonville
- UF Health Leesburg
UF Health has stated people enrolled in the UF Student Health Insurance Plan through Student Resources will not be impacted. To clarify, UF Health will be out of network for our Student Resources plan, meaning you could face a higher cost share should you receive services from a UF Health provider.
We encourage people enrolled in our Student Resources plan to speak to their UF Health provider to understand the additional costs they could face should they choose to see their provider out of network.
We are committed to continued good-faith negotiation with the goal of restoring network access to UF Health. However, we need UF Health to join us at the negotiating table.
Our top priority is ensuring you and your family have access to the care you need. Please know you continue to have access to thousands of physicians and a robust network of hospitals in your area. Some examples of hospitals remaining in our network in the impacted areas include but are not limited to:
- AdventHealth Palm Coast
- AdventHealth Palm Coast Parkway
- Ascension St. Vincents Riverside
- Ascension St. Vincents Southside
- Baptist Medical Center
- Baptist Medical Center-Beaches
- Baptist Medical Center-Nassau
- HCA Florida Memorial Hospital
- HCA Florida North Florida Hospital
- HCA Florida Orange Park Hospital
- Mayo Clinic Florida
- Wolfson Children’s Hospital
For assistance finding an alternative hospital or physician in your area, please call the number on your health plan ID card. You can also use the provider directory on our member website – www.myuhc.com to search for alternative hospitals and doctors.
If you or someone in your family is in the middle of treatment at a UF Health hospital, facility or with a UF Health physician when they went out of network, you may qualify for continuity of care. Continuity of care provides continued in-network benefits for a specified period of time after a provider leaves our network. A few examples of patients who may qualify include:
- Mujeres embarazadas
- Patients with newly diagnosed or relapsed cancer, or those currently in active cancer treatment.
If you or someone in your family has questions about continuity of care and whether you might be eligible, please call the number on your health plan ID card.
We have made numerous efforts to compromise in the spirit of good-faith negotiation with the goal of reaching an agreement.
In fact, we agreed to the terms UF Health sought to continue participation in our Medicaid network. We delivered a contract to the health system to finalize on Aug. 31, only for UF Health to not respond to the proposal and unnecessarily disrupt access to care for approximately 30,000 people enrolled in our Medicaid plans who rely on UF Health for their health care needs.
We also provided another proposal to UF Health on Aug. 30 that included significant movement for our employer-sponsored commercial plans. Our proposal included meaningful rate increases on top of what we’d already proposed, ensuring UF Health continues to be reimbursed similar to their peers in the market. UF Health never responded to our proposal.
The last proposal we received from UF Health was on Aug. 29 and included demands for a 30% price hike over two years and a more than 20% rate increase in just the first year of our contract, which is not affordable or realistic for Florida families and employers.
Your prescription drugs would still be covered so long as you receive them from an in-network pharmacy, regardless of whether the prescribing physician participates in our network or not. If you need assistance finding an in-network pharmacy in your area, please call the number on your health plan ID card.
People enrolled in our Group Retiree PPO plan may still receive care from a UF Health physician or facility as an out-of-network provider, if they are a Medicare-approved provider that accepts the plan. Your share of the cost will be the same as if they were part of the network.
UnitedHealthcare Group Retiree members are encouraged to speak with their physician to confirm they’ll continue to see them, regardless of their network status.
For additional information about our Group Retiree plan as well as information on how to find a provider in their area, UnitedHealthcare members should go to retiree.uhc.com.
In the event of an emergency, UnitedHealthcare members should always go to the nearest hospital. Their services will be covered at the in-network benefit level, regardless of whether the hospital participates in UnitedHealthcare’s network.