Update on United Healthcare Negotiations

Why is OU Health Negotiating with United Healthcare and Willing to Go Out of Network?

OU Health is working to negotiate a new contract with UnitedHealthcare (UHC). We began our negotiations in November of 2021, and continue to remain far apart on the issues, which will cause OU Health to go out of network with UHC on May 1, 2022.

UHC has refused to reimburse Oklahoma’s flagship academic health system and only multi-specialty, research-driven physician group, at a rate that keeps up with inflation as well as the increasing needs of our patients and our ability to deliver unique and life-saving therapies to the state and region.In fact, UHC is asking OU Health to take a 39 percent rate cut for our physicians and 20 percent cut for our facilities at a time when their profits have hit record highs, growing by $10 billion last year. UHC asking our physicians and nurses to take a cut of this size is egregious. A decrease of this kind is simply not sustainable to our mission and is unacceptable to our physicians, nurses and the care of our patients.

Oklahoma’s most complex and ill patients come to OU Health for access to doctors and treatment available nowhere else in the state or region, benefiting the individual patient, the state, and all of healthcare through specialized treatment that leads to life-saving new discoveries.

UHC has recorded windfall profits in the past year, and yet they are undervaluing the flagship academic health system of Oklahoma that is home to the state’s only NCI-Designated cancer center, only comprehensive children’s hospital, and the most specialized group of physicians in the region.

Even more disheartening, UHC claims they accelerated nearly $2 billion of payments to care providers to provide needed liquidity for the health system, but OU Health was not included in that national initiative. While we are extremely grateful to have received $74 million in CARES Act funding, this covered only a fraction of the losses that OU Health – like all other healthcare facilities – have experienced over the past 26 months. Justifying their demand for rate cuts by highlighting much-needed relief funding from the COVID-19 pandemic is insulting to our team who risked their lives to care for patients during the most stressful time in healthcare.

Oklahoma deserves and needs a level of healthcare that only we can provide and this cannot continue to happen for our UHC-covered patients if UHC cuts its reimbursement to OU Health. The contract termination deadline is April 30, 2022, and we are deeply concerned about not reaching an agreement.

Why is OU Health Negotiating?

For our state to be healthier, Oklahomans needs access to world-class, research-driven healthcare. UHC is undervaluing the state’s largest, most highly specialized, research-driven physician group by insisting on reducing OU Health's provider reimbursement by 39 percent and the facilities in which they practice by 20 percent. We cannot invest in our academic, research and clinical care missions if UHC undervalues us and continues to hold onto their profits.

Why Does This Matter?

By undervaluing the state’s only specialized group of research physicians, only NCI-designated cancer center and only comprehensive children’s hospital, UHC shortchanges Oklahomans by keeping their record profits and not reinvesting in improved healthcare for all.

UHC claims OU Health is the most expensive provider in Oklahoma. As the flagship academic health system, it is our responsibility to care for all of the state’s most complex and seriously ill patients. Taking care of such high acuity patients is our duty to the state and our covenant to the community. UHC comparing our expenses to those of a community hospital does not factor the overall cost of care for those complex patients. The national cost per unit averages for academic health centers on standardized procedures is 15% higher than the cost per unit averages for community hospitals, while total cost of care for academic health systems averages 25% lower.

The bottom line is this: UHC is not willing to provide necessary reimbursements, even though we are the state’s most specialized group of research physicians utilizing the state’s most specialized health facilities. Instead, they are keeping their record windfall profits from an unprecedented and deadly pandemic, rather than investing it in Oklahoma healthcare. UHC is further harming Oklahomans by driving healthcare dollars out of state and forcing our citizens to have to travel hundreds of miles to find in-network specialty care.