Hailey Tran
Boca Raton Regional Hospital ended its contract with UnitedHealthcare, the nation's largest health insurer, in 2019, affecting over 17,000 patients. This contract dispute has resulted in patients facing higher out-of-network costs and scrambling to find alternative healthcare providers. While Zocdoc allows users to search for UnitedHealthcare doctors in Boca Raton, it is unclear whether these doctors are affiliated with Boca Raton Regional Hospital.
| Characteristics | Values |
|---|---|
| Does Boca Regional Hospital accept United Healthcare? | No, Boca Regional Hospital ended its contract with United Healthcare in 2019. |
| Reason for ending the contract | United Healthcare was unwilling to reimburse the hospital at "market competitive rates". |
| Effect of the contract termination | More than 17,000 patients were left scrambling to find another healthcare provider or go out of network. |
| Alternative options for patients | Patients can use Zocdoc to find UnitedHealthcare doctors in Boca Raton. |
| Other hospitals that accept United Healthcare | Delray Medical Center |
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What You'll Learn
- Boca Regional Hospital ended its contract with United Healthcare in 2019
- This affected over 17,000 patients
- United Healthcare is the nation's largest health insurer
- United Healthcare was unwilling to reimburse the hospital at market-competitive rates
- Patients can use Zocdoc to find UnitedHealthcare doctors in Boca Raton
Boca Regional Hospital ended its contract with United Healthcare in 2019
Boca Raton Regional Hospital, now part of Baptist Health, ended its contract with United Healthcare, the nation's largest health insurer, in 2019. This affected over 17,000 patients, who were forced to either find another healthcare provider or go out of network.
The contract ended on June 30, 2019, after the hospital and insurance company failed to reach a new agreement. United Healthcare stated that it wanted to continue serving local patients, but claimed that its self-funded customers would face an additional $3.2 million in healthcare costs over the next year if it agreed to the hospital's demands. This would affect members enrolled in employer-sponsored, individual, Medicare Advantage, and Medicaid health plans.
In a letter to patients, Boca Raton Regional Hospital explained that United Healthcare was unwilling to reimburse the hospital at "market competitive rates". As a result, patients faced higher "out-of-network" costs, with some reporting that their out-of-pocket deductible caps had increased significantly.
The end of the contract also impacted the availability of certain medical services and practitioners for United Healthcare patients. Some patients shared their concerns about the inconvenience and financial burden caused by having to seek alternative care and find new doctors and hospitals.
It is important to note that the merger of Boca Raton Regional Hospital with Baptist Health did not cause the expiration of the United Healthcare contract. Baptist Health accepts United Healthcare at its other facilities and has expressed its intention to help Boca Raton Regional Hospital reach a new agreement with the insurer.
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This affected over 17,000 patients
Boca Raton Regional Hospital, located in the heart of Boca Raton, is a nationally-ranked medical center that delivers expert medical care to patients across southern Palm Beach County. The hospital offers emergency services, orthopedic care, minimally invasive surgery, maternity care, and advanced diagnostic imaging. It is also home to nationally recognized centers of excellence, including the Eugene M. & Christine E. Lynn Cancer Institute, Lynn Heart & Vascular Institute, Marcus Neuroscience Institute, and Lynn Women's Health & Wellness Institute.
In 2019, Boca Raton Regional Hospital ended its contract with United Healthcare, the nation's largest health insurer. This decision affected over 17,000 patients, who were left with the difficult choice of finding another healthcare provider or going out of network. United Healthcare subscribers would face much higher medical bills if they sought treatment at Boca Raton Regional Hospital, even for emergency care.
The hospital, which is part of Baptist Health, had been attempting to negotiate a reasonable agreement with United Healthcare before the contract's expiration on June 30, 2019. However, United Healthcare stated that agreeing to the hospital's demands would result in an additional $3.2 million in healthcare costs for their self-funded customers. This impacted members with employer-sponsored, individual, Medicare Advantage, and Medicaid health plans.
The situation caused inconvenience and disruption for thousands of patients, who had to navigate finding alternative healthcare providers or incurring higher out-of-network costs. It also highlighted the complex dynamics between healthcare providers and insurance companies, with patients often caught in the middle.
To mitigate the impact on patients, United Healthcare offered ""Continuity of Care," allowing members undergoing treatments like chemotherapy or radiation therapy as of July 1, 2019, to continue receiving in-network costs. However, long-term, patients had to seek new hospital service providers for these treatments and lost access to certain services at Boca Raton Regional Hospital, such as maternity services.
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United Healthcare is the nation's largest health insurer
UnitedHealthcare is the nation's largest health insurer. It offers a range of individual and family health insurance plans, including ACA Marketplace plans, Medicare Advantage plans, and Medicaid plan options. The company was founded in 1977 as UnitedHealthcare Corporation to create a network-based health plan for seniors. It became a publicly traded company in 1984 and changed its name to UnitedHealth Group in 1998.
UnitedHealthcare is organized into four main divisions: UnitedHealthcare Employer and Individual, UnitedHealthcare Medicare and Retirement, UnitedHealthcare Community and State, and Optum. The company provides health benefit plans and services for large national employers and individuals, health and well-being services for individuals aged 65 and older, and serves state programs that care for the economically disadvantaged, the medically underserved, and people without employer-funded healthcare coverage.
UnitedHealthcare has faced several lawsuits and controversies over the years. In 2008, the California Department of Insurance took action against its subsidiary PacifiCare Health Systems, resulting in a fine of around $173 million. In 2009, UnitedHealth Group settled three class-action lawsuits for $350 million, and in 2013, it paid a $536,000 fine for violating state insurance laws in Missouri.
Despite these controversies, UnitedHealthcare has grown significantly. In 2022, the company's total revenue topped $400 billion, a 55% increase from the previous year. UnitedHealthcare serves more than 50 million people across the nation, making it the largest health insurer in the United States.
Regarding Boca Regional Hospital, it was reported in 2019 that the hospital ended its contract with United Healthcare, affecting over 17,000 patients. However, Zocdoc lists doctors at Boca Raton Regional Hospital who are in-network with UnitedHealthcare, indicating that the hospital may have since renewed its contract with the insurer.
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United Healthcare was unwilling to reimburse the hospital at market-competitive rates
Boca Raton Regional Hospital ended its contract with UnitedHealthcare, the nation's largest health insurer, in 2019. This affected over 17,000 patients, who were forced to either find another healthcare provider or go out of network. The hospital had been trying to negotiate a reasonable agreement with UnitedHealthcare before the contract's expiration date of June 30, but to no avail.
UnitedHealthcare's reluctance to reimburse the hospital at market-competitive rates was the primary reason for the contract termination. Boca Raton Regional Hospital, now part of Baptist Health, stated that UnitedHealthcare's rates would result in higher out-of-network costs for patients, particularly those with AARP Medicare Advantage plans. For instance, one patient reported that his out-of-pocket deductible cap increased from $6,000 to $10,000, and he was required to pay 40% of the total cost for unlimited hospital days.
The dispute between Boca Raton Regional Hospital and UnitedHealthcare had been ongoing for several years. The hospital's management had decided that they could no longer afford to work with the largest health insurance provider in the country, as UnitedHealthcare was reportedly unwilling to offer reimbursement rates that reflected the hospital's costs. This decision was not made lightly, as the hospital understood the significant impact it would have on patients.
UnitedHealthcare's response to the contract termination was to emphasize their desire to serve local patients. However, they acknowledged that their self-funded customers would face additional costs if they agreed to the hospital's demands. The company stated that their customers would incur an extra $3.2 million in healthcare costs over the next year for their employees' care.
The end of the contract between Boca Raton Regional Hospital and UnitedHealthcare highlights the complex nature of healthcare reimbursement and insurance coverage. While UnitedHealthcare prioritized cost management, the hospital focused on ensuring market-competitive rates to maintain their financial viability and provide quality patient care. Unfortunately, the failure to reach an agreement resulted in significant disruptions for thousands of patients, who were forced to navigate higher out-of-network costs or seek alternative healthcare providers.
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Patients can use Zocdoc to find UnitedHealthcare doctors in Boca Raton
Zocdoc lets you search specifically for doctors in Boca Raton who take UnitedHealthcare insurance. To do this, choose your carrier and plan from the drop-down menu at the top of the page. If you're not sure which plan you have, you can use Zocdoc's insurance checker to find out. You can also search for UnitedHealthcare doctors in Boca Raton by symptom or visit reason.
Zocdoc verifies all providers before they can appear in the search results. Every provider that appears in the search is open to new patients. Zocdoc only allows patients to write reviews if they can verify that they have seen the provider. Providers cannot request to alter or remove reviews.
Patients can also use Zocdoc to find pulmonologists and primary care doctors in Boca Raton who take UnitedHealthcare Oxford insurance. Doctors in Boca Raton on Zocdoc who see patients through online video visits will have a purple video icon on their profiles. You can also filter your search results to show only doctors who offer video visits. Most insurers provide coverage for video visits at the same cost as in-person visits.
It is important to note that Boca Raton Regional Hospital, which is now part of Baptist Health, ended its contract with United Healthcare in 2019. This affected more than 17,000 patients, leaving them to choose between finding another healthcare provider or going out of network.
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Frequently asked questions
No, Boca Raton Regional Hospital ended its contract with United Healthcare in 2019.
United Healthcare was unwilling to reimburse the hospital at market-competitive rates.
The end of the contract means higher "out-of-network" costs for patients. Patients are left choosing between finding another healthcare provider or paying higher costs.
Yes, you can use Zocdoc to find UnitedHealthcare doctors near Boca Regional Hospital.
Yes, most insurers, including United Healthcare, provide coverage for video visits at the same cost as in-person visits.
