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Tucson Doctors Call for Urgent Peace Between Northwest and UnitedHealthcare Before Deadline Looms

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Tucson doctors urge Northwest and UnitedHealthcare truce before deadline


Southern Arizona’s largest physician group is urging Northwest Healthcare and UnitedHealthcare to resolve their contract dispute promptly for the benefit of patients.

“If the impasse is not bridged, where will these folks go — the emergency room or walk-in clinic?” questioned Dr. Susan Kolata, President of the Pima County Medical Society.

The deadline for contract negotiations is Monday, and as of Friday afternoon, there was no resolution in sight. The standstill could severely impact thousands of Tucson-area residents who rely on UnitedHealthcare.

The potential contract termination would prevent these residents from accessing Northwest Healthcare’s facilities and services, except in emergencies. This includes primary care physicians, urgent care facilities, and hospitals such as Oro Valley Hospital and Northwest Medical Center.

“We remain committed to reaching an agreement with Northwest Healthcare that preserves access to the important care Northwest provides in the Tucson community,” said UnitedHealthcare officials in a prepared statement.

UnitedHealthcare’s Arizona Health Plan CEO, Dave Allazetta, met with Northwest Healthcare CEO, Kevin Stockton, on Thursday but no agreement was reached.

Should the contract end, UnitedHealthcare’s Medicaid, Medicare Advantage, and commercial plans would be impacted. However, there is a transition-of-care plan in place for ongoing treatment cases and specific circumstances, like third-trimester pregnancies.

Northwest Healthcare, owned by Community Health Systems, stated late Friday that they are hopeful for a resolution as negotiations continue.

Dr. Kolata emphasized the need for both parties to prioritize patient welfare. “To do otherwise would be unthinkable,” she said. She highlighted the irreplaceable role of long-term doctors compared to ERs and walk-in clinics.

This situation is unprecedented according to Dr. Tim Fagan, Pima County Medical Society board member. He estimates that 20-40 percent of patients served by Northwest Medical Center and Oro Valley Hospital are covered by UnitedHealthcare.

“We’re talking about tens of thousands of patients. We already have a shortage of primary-care doctors and other specialties in the Tucson area,” added Fagan. “This could overburden other hospitals and systems in the region.”

Healthcare strategist Nathan S. Kaufman noted such disputes are often resolved at the eleventh hour, although outcomes can vary. “It depends on the relative power of each side,” Kaufman stated, emphasizing the importance of geographical indispensability in negotiations.

Northwest’s facilities fulfill a significant geographical need, especially for seniors and residents of Marana and Oro Valley, who might face longer commute times to access alternative healthcare if the dispute is unresolved.

Both parties have engaged the public via newspaper op-eds and communication with patients. Northwest Healthcare mailed over 60,000 letters to UnitedHealthcare patients and created the website “Stand Up to United Az.”

This dispute mirrors a 2015 conflict between BlueCross BlueShield of Arizona and the Southern Arizona Carondelet Health Network, though it poses potentially greater consequences due to its mid-year timing, which limits patients’ ability to change insurance plans.

UnitedHealthcare and Northwest Healthcare present conflicting views on the dispute’s core issues. Northwest claims UnitedHealthcare seeks a 25 percent reduction in reimbursements, while UnitedHealthcare asserts Northwest demands a 27 percent rate increase over the next three years.

UnitedHealthcare also criticizes Northwest Healthcare for not adopting a value-based reimbursement model focused on quality metrics, which other local hospitals have accepted. Northwest, however, states they comply with quality-based programs with other insurers.

Kaufman noted that public opinion can be a decisive factor in negotiations. “If United beneficiaries threaten to leave, United might cave. Conversely, if United is confident the patients can be relocated, the hospital might have to relent.”

For more information, contact health reporter Stephanie Innes at 573-4134 or email sinnes@tucson.com.