Ascension Wisconsin, UnitedHealthcare reach deal to restore in-network access

Patients with UnitedHealthcare insurance once again have in-network coverage at Ascension Wisconsin hospitals and doctors’ offices.

United and Ascension Wisconsin announced Tuesday that they reached a new multi-year agreement to give United members access to Ascension’s hospitals and providers in Wisconsin.

According to United, the deal is effective immediately and retroactive to Oct. 1, the day the insurer’s members lost coverage when the two sides failed to reach an agreement in a dispute over reimbursement rates.

According to an Ascension Wisconsin spokesperson, services that patients received from Oct. 1 to Oct. 13 will be covered at in-network rates and patients should not be billed for out-of-network costs.

In a statement, Dustin Hinton, CEO of UnitedHealthcare Wisconsin, said the agreement restores access for people enrolled in United’s commercial, Medicare Advantage and Medicaid plans.

“Our top priority throughout the negotiation was to reach an agreement that was affordable for consumers and employers, and this agreement helps accomplish that goal,” he said.

UnitedHealthcare said it is mailing letters out to members to let them know that Ascension Wisconsin is back in-network.

Daniel Jackson, CEO of Ascension Wisconsin, described the agreement as “more than just a contract” in a statement issued Tuesday. 

“It is a reaffirmation of our Mission to serve all with dignity and compassion,” Jackson stated. “By securing fair and sustainable reimbursement, we are able to continue supporting our caregivers, strengthening our ministries, and providing high-quality, compassionate care across the communities we serve.”

In its announcement, the health system also said that it was grateful to patients, providers and partners for their patience throughout the negotiation process. 

Ascension Wisconsin said it is not providing interviews with health system officials at this time.

Before reaching a deal Ascension and United had been locked in a months-long contract dispute. Ascension argued United was not offering reimbursement rates that covered rising health care costs, while United argued Ascension was asking for large price hikes that would raise costs for customers and employers. 

Other negotiations between Ascension affiliates and UnitedHealthcare had gotten close to the deadline before the dispute in Wisconsin. Ascension Florida had to reach a short-term agreement with United to stay in the network during negotiations earlier this year before both sides came to a multi-year agreement.

Dan Sacks, an associate professor of risk and insurance at the University of Wisconsin School of Business, said contract disputes are a normal part of the negotiation process between health care providers and health insurers.

He said their contracts dictate what insurers pay hospitals and influence how much patients pay. But he also said it’s rare for talks to break down like they did in this case.

“It’s costly for Ascension if patients end up canceling scheduled visits. It’s very costly for patients if their care is disrupted,” Sacks said. “It ends up being costly for United if some people decide that they would rather go to a different insurer.”

Sacks said both sides reaching a deal is “absolutely good news” for United members and Ascension patients, but it’s not such good news for those who began looking for alternative providers or canceled visits.

“For the patients who arguably did the prudent thing and rescheduled visits or canceled visits and looked for an alternative provider, they really have no recourse,” he said. “They lost a chance to get health care that they thought they were entitled to when they signed up for insurance, and now that care is delayed or it may never happen.”