HCA and UnitedHealth reach agreement before coverage interruption in 4 states

HCA Healthcare, the nation’s largest hospital chain, and UnitedHealthcare finalized their contract terms, keeping patients in-network in Texas, Colorado, South Carolina, and New Hampshire.

Shortly before their contracts were scheduled to expire on September 1, HCA Healthcare, the nation’s largest hospital chain, and UnitedHealthcare reached multi-year agreements, capping a months-long dispute that threatened health care access at 38 hospitals and affiliated providers across four states.

HCA and UnitedHealth had been in contract talks for months but to no avail before they struck a deal on Saturday evening. Otherwise, network coverage would have been interrupted for members.

“UnitedHealthcare and HCA have reached a multi-year contract that ensures continued, uninterrupted network access to their providers for people enrolled in employer-sponsored commercial plans …as well as our Medicare Advantage plans, including Group Retiree,” according to a UnitedHealthcare statement. “We also extended network access to all of these providers for people enrolled in our Individual Family Plan (IFP) through Dec. 31, 2024.”

If the deal had not been struck on September 1, HCA’s 38 hospitals and their affiliated physician groups and surgery centers across four states – Texas, Colorado, South Carolina and New Hampshire – would have become out-of-network for UnitedHealthcare members.

HCA Healthcare is the nation’s largest provider of health care services comprising 200 hospitals and 2,300 ambulatory sites of care in 21 states. HCA’s facilities include surgery centers, freestanding ERs, urgent care centers and physician clinics.

Earlier this year, HCA lost a bid to dismiss a proposed class action lawsuit in North Carolina federal court, accusing it of scheming to restrict competition and artificially drive up costs for health plans.

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The lawsuit alleged that HCA engaged in an “anticompetitive scheme involving the illegal maintenance and enhancement of monopoly power” in the acute care hospital and outpatient care markets in seven counties in North Carolina. HCA called the allegations “baseless” and said they serve only to “increase hospitals’ cost of doing business in the form of high litigation expenses,” in court papers.

UnitedHealthcare, the country’s largest health care insurer, has also been involved in multiple disputes with large hospital systems this past year. In August, the insurer reached an agreement on a new multi-year contract with Trinity Health, after lengthy negotiations.