WakeMed, UnitedHealthcare Contract Dispute Threatens Coverage for Thousands
Raleigh, NC – WakeMed and UnitedHealthcare are locked in a contract dispute that could leave patients with Medicare Advantage plans without in-network coverage starting Saturday, November 15th, potentially disrupting healthcare access for many in the region.
Negotiations between the two organizations have stalled, with both contracts set to expire this weekend. UnitedHealthcare officials state that WakeMed is seeking a nearly 40% price increase, including a 30% jump in the first year alone, which would make it the most expensive health system in the Raleigh market. “WakeMed is demanding a near 40% price hike, including a 30% rate increase in just the first year of our contract that would make it the most expensive health system in the Raleigh market,” UnitedHealthcare said in a statement. They are proposing “meaningful rate increases that continue to reimburse WakeMed at market-competitive rate.”
WakeMed officials, however, say they walked away from discussions specifically related to Medicare Advantage plans after UnitedHealthcare ceased negotiations on November 7th. They argue that UnitedHealthcare’s proposed rates are unsustainable, failing to keep pace with rising costs for supplies, equipment, and labor. “We cannot accept the terms UHC has proposed to date, as they put WakeMed at risk for being able to take care of our community and deliver on our mission of caring for all,” WakeMed stated. This dispute highlights the ongoing challenges in healthcare pricing and reimbursement rates. WakeMed also claims its current rates from UnitedHealthcare are significantly lower than those paid to other hospitals in the Triangle area, impacting their ability to attract and retain staff, as well as invest in new services – a common issue facing hospital finances.
If an agreement isn’t reached by Saturday, the out-of-network status will extend beyond Medicare Advantage plans to include employer-sponsored and individual commercial plans. Both organizations say they remain open to further discussion and are hopeful a resolution can be found, but officials with WakeMed stated they are working diligently to negotiate with UnitedHealthcare, with the “intent of staying in-network.”
