UnitedHealthcare CEO responds to lawmaker's physician network questions: 3 takeaways

Morgan Haefner – June 17, 2020

On May 26, U.S. Rep. Katie Porter, D-Calif., sent a letter to David Wichmann, CEO of UnitedHealth Group, that questioned whether the health insurance company has moved to narrow its provider network and decrease reimbursement during the pandemic.

In a June 12 letter to Ms. Porter, Rob Falkenberg, CEO of UnitedHealthcare in California, responded to her questions. Here are three takeaways from his letter, which was shared with Becker's Hospital Review:

1. Addressing Ms. Porter's assertion that recent moves to terminate provider contracts have led to narrower provider networks, Mr. Falkenberg said UnitedHealth has added 100,000-plus physicians to its network in the last year, with about 19,000 of them added in 2020. 

2. From January through May 2020, Mr. Falkenberg said contracts with 1.5 percent of UnitedHealth's network physicians were terminated, and "the majority of these terminations were either initiated by the physicians themselves or were the result of administrative issues such as the provider losing admitting privileges at an in-network hospital."

3. Of the more than 2,000 contracts UnitedHealth negotiates each year, Mr. Falkenberg said most contract disputes don't end in termination. "When comparing the number of physicians who left the network with the number who joined, our network grew by nearly 5,400 physicians from January through May of 2019 and by more than 8,000 physicians during that same timeframe this year," the letter reads.

To learn more about Ms. Porter's letter to UnitedHealth Group, click here.

https://www.beckershospitalreview.com/payer-issues/unitedhealthcare-ceo-responds-to-lawmaker-s-physician-network-questions-3-takeaways.html