NORTH PROVIDENCE - United Healthcare wants to stop insurance coverage of patients in two Catholic hospitals, but it won't happen without a fight.
Officials of St. Joseph Health Services of Rhode Island, which operates Our Lady of Fatima Hospital and St. Joseph Hospital for Specialty Care, held a press conference at Our Lady of Fatima Hospital Tuesday, calling on United Healthcare to rescind its application to the Rhode Island Dept. of Health that would permit the insurer to remove the hospitals from the United Provider network.
"To the best of our knowledge, this may not be the first time a Rhode Island insurer has taken such a drastic action, but we understand that no insurer has taken the process so far," said John Keimig, president and CEO of St. Joseph Health Services. "It is an action that that this organization intends to oppose with every means available to us."
Keimig said United's action came "at the 11th hour of our prolonged negotiations to renew our United contract." That process began in December 2006, three months prior to the contract's termination date. The hospital agreed to two extensions after the original termination date, adding another 45 days to the time to negotiate a fair and equitable settlement.
"Our negotiating posture has and remains grounded in a simple tenet - that our organization deserves to be reimbursed by United at rates that are comparable to those we receive from other commercial insurers," Keimig said. "United has consistently balked at this request, and the parties today remain far apart. Indeed, as late as 9:45 p.m. Sunday (April 15), we filed another offer with United in an attempt to break our stalemate."
A United Healthcare press release stated: "We are trying to find a common ground that will prevent higher costs for consumers and Rhode Island employees while providing access to the health care services needed. We want St. Joseph's Health Care Services to remain in our network and have been working very hard to reach a mutually beneficial agreement."
Keimig said that in filing the application to remove the hospitals from their network, "United has crossed a dangerous line. While our organization may be nothing more than a line item on United's income statement, we are much more than that to the people of Rhode Island. We offer an important option to those thousands of United subscribers who choose to receive hospital care in our uniquely faith-based, Catholic environment. United would seek to disenfranchise not only Catholics, but many Rhode Islanders from a health care choice that has been available to them for over a century."
Keimig said that United is exhibiting a level of corporate irresponsibility that has seldom been seen in Rhode Island. He noted that the company earned more than $5 billion in profits last year nationally, and paid its CEO $124 million in compensation a figure that the hospital president said is approximately 150 percent of the total annual payroll for all of the hospital's 2000 employees. The hospital president also added that United Healthcare recently tried to transfer $38 million in extraordinary profits to the insurer's corporate headquarters in Minnesota.
"It is the same company that is distorting our current rate request by not telling the whole story of how, for many years prior to 2005, this hospital received a zero percent increase or a very small single digit increase," Keimig said. "This is the same company whose cumulative earnings from operations increased over 4,000 percent between 1997 and 2006, while our commercial rates increased an average of 3.8 percent a year.
"All we are asking for is for is an equivalent of a small fraction of those excess profits so we can continue our mission and take care of all patients in a quality manner, not just United subscribers," Keimig continued. "We remain open and anxious to continue our discussions with United, but we expect good faith to return. We are asking United to withdraw its application to withdraw its application to the Dept. of Health that would remove us from their network. And, we are asking United to return to the negotiating table ready to offer us reimbursement that is fair and just."
Keimig concluded by saying that St. Joseph Healthcare Services is committed to return to negotiations in order to reach a mutually-agreeable contract that will give the health care provider a level of compensation that is comparable to what it receives from other commercial health insurers.
In a statement delivered by Msgr. Paul Theroux, Moderator of the Curia for the Diocese of Providence, and vice chairman of the Board of Trustees of St. Joseph Healthcare, Bishop Thomas J. Tobin expressed his concern over the contract dispute.
"As Bishop of the Diocese of Providence and Chairman of the Board of Trustees of our diocesan-sponsored hospital, I am deeply disappointed by the actions that United Healthcare has undertaken to begin the formal process to exclude the only Catholic hospitals in Rhode Island from the United Network," Bishop Tobin stated.
"I understand corporations such as United must manage its expenses," he added. "But this should not and cannot come at the expense of the capabilities that we have, through careful and prudent stewardship, developed over the years." (See accompanying article for the full text of the Bishop's statement.)
Dr. A. Robert Buonanno, chairman of the department of surgery at Our Lady of Fatima Hospital, represented the medical staff at the press conference.
"I think that it would be fair to characterize the medical staff's reaction to United Healthcare's decision as dismayed, disappointed and very worried for our patients...." said Dr. Buonanno. "There are many members of our medical staff who are United providers and practice either exclusively or primarily at this hospital, and do not wish to practice elsewhere. This action would wreak havoc with our patient referral patterns and would, in absolute terms, hurt people who are trying to recover from illness or injury. As physicians, we think of people before profits, and sincerely hope that United will come to this same point of view."
The United Healthcare press release stated that its members may continue to seek care at St. Joe's facilities at no additional cost to the insured party, adding that the hospital will remain an in-network facility. If there are any changes, members will be contacted directly.
(This article originally appeared in The Providence Visitor)
