Patient Anxiety Soars Amid Prolonged Northwest-UnitedHealthcare Impasse

A looming May 1 deadline has intensified a contract dispute between UnitedHealthcare and Northwest Healthcare, potentially impacting thousands of patients in Tucson.

Both institutions have notified patients that they may lose access to services at facilities like Northwest Medical Center and Oro Valley Hospital, barring emergencies. Northwest Healthcare, owned by Community Health Systems in Tennessee, is a major provider in the area.

This potential contract termination could affect a range of UnitedHealthcare plans, including Medicaid, Medicare Advantage, and commercial plans. Patients and providers are feeling the strain, with significant disruptions looming over scheduled surgeries and ongoing treatments. “If we don’t get privileges at another hospital, we will lose our contracts with United,” said Monica Humphrey, practice administrator at Northwest Neuro-Specialists.

Patients, particularly seniors and those with chronic conditions, are anxious about having to find new doctors and travel further for care. An estimated 60,000 letters were sent to UnitedHealthcare members who utilized Northwest Healthcare services in the past year.

This conflict echoes a 2015 dispute between BlueCross BlueShield of Arizona and the Southern Arizona Carondelet Health Network but is more pressing for patients as it occurs mid-year, outside of open enrollment periods. “Why can they change if we can’t? I’d rather keep my doctors than my plan,” remarked Oro Valley resident Elena Oldakowski.

While there are some consumer protections, such as continuation of care for those with special conditions or pregnant women, uncertainty abounds. Kevin and Linda Davis, dealing with a rare cancer diagnosis, are awaiting approval from UnitedHealthcare to continue treatment with their current doctors.

Independent insurance broker Denise Early believes a settlement is likely given UnitedHealthcare’s significant presence in Tucson but acknowledges past instances where patients were left without resolution.

The SaddleBrooke retirement community is particularly concerned, with residents potentially having to travel an hour for care to Tucson Medical Center or Carondelet hospitals. “People are extremely concerned,” shared Don Jensen, a resident who recently underwent foot surgery at Oro Valley Hospital.

Phyllis Ebeling, a long-term patient of Dr. Thomas Scully, fears the dispute will force her to incur high out-of-network costs to remain with her trusted neurosurgeon.

Northwest Healthcare has launched “Stand Up To United,” a website urging patients to protest the insurer’s terms. UnitedHealthcare claims Northwest is resisting a value-based reimbursement model focused on quality measures, while Northwest sees the demands as untenable. “We are really trying to change the way they are compensated,” said Dave Allazetta, CEO of UnitedHealthcare’s Arizona Health Plan.

Northwest CEO Kevin Stockton remains hopeful for a resolution but notes a lack of response from UnitedHealthcare to their latest counteroffer. “We’re committed to reaching an agreement,” Stockton emphasized, hoping for a calm, reasoned resolution soon.

Contact health reporter Stephanie Innes at 573-4134 or email sinnes@tucson.com. Follow on Twitter: @stephanieinnes