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Some 80,000 United Healthcare insurance holders in Georgia face the threat of having Wellstar facilities become out-of-network on Sunday.

It’s the eleventh hour in the ongoing contract dispute between Wellstar and United Healthcare, with no indication the two healthcare giants are close to agreeing on terms.

If they don’t, some 80,000 patients will have their healthcare thrown into jeopardy when the current contract expires on Sunday.

The two groups have engaged in a steadily escalating PR battle in recent months, with both sides accusing the other of prioritizing cash flow over care. United contends Wellstar is seeking “egregious” rate increases which would make them the most expensive hospital network in metro Atlanta, increasing care costs by some $75 million in the first year alone.

Wellstar, meanwhile, has said United has been “woefully underpaying” for healthcare, and contrasted its nonprofit status with United—a publicly-traded firm which turned a $22 billion profit in 2020.

“We are asking United Healthcare to prioritize patients over its bottom line by providing fair compensation so that Wellstar can continue to meet your care needs,” Wellstar writes on a web page dedicated solely to the dispute.

As Wellstar notes, United has played a similar hand in recent negotiations with other providers, most recently Northside Hospital.

“Northside’s Atlanta, Cherokee and Forsyth hospitals are the most expensive in Atlanta, and for cancer patients, they’re some of the most expensive places in the entire country to receive care,” United told Georgia Health News in June during a previous contract dispute.

The tit-for-tat appears to have resulted in little progress in the talks.

“Wellstar has provided four proposals, and while it has dropped its price hike demands slightly, the rates it’s demanding remain egregiously high,” United said on Monday, saying the latest proposal had decreased the first-year rate hike from 22% to 16%. “Unfortunately, there are no indications, based on Wellstar’s latest proposal received on Sept. 21, that our message is getting through to Wellstar.”

United did share one positive update for its senior patients, saying those with Medicare Advantage Group Retiree plans will continue to be able to access Wellstar facilities for no additional cost. But those carrying individual Medicare Advantage plans — like Kennesaw resident Sue Gantt, a United customer who was notified by mail of her impending loss of Wellstar access — won’t.

“Wellstar has confirmed it will continue to provide care to members enrolled in the UnitedHealthcare Group Medicare Advantage National PPO plan, including the Medicare Advantage State Health Benefit Plan for retirees,” United said in a statement to the MDJ. “As a result, all members enrolled in this plan will continue to have access to Wellstar’s hospitals and physicians even if they go out of network. Our Group Medicare Advantage National PPO plan gives our members the flexibility to see care providers that don’t participate in our network for no additional out-of-pocket cost beyond what they would pay to see a network provider.”

When faced with an emergency, according to United, patients should not have to worry about where to seek care. United told the MDJ that “in the event of an emergency, our members should go to the nearest hospital and the services will be covered as in-network, regardless of the hospital’s network status.”

A staff member at one Wellstar medical practice in Cobb County told a United customer this week that they were not booking doctor’s visits until November in the hope that the contract dispute would be worked out by then.

Jerry Burton, another United customer in Kennesaw, said he has little sympathy for either party in the spat. Writing to the MDJ, Burton said he’s offended by Wellstar’s “‘poor little me’ approach” in the war of words.

“What interested me was Wellstar claiming to be the ‘non profit’ little guy fighting for my rights against a profit seeking corporation. Granted Wellstar is a non profit but the executives sure are not,” Burton wrote.

Wellstar CEO Candace Saunders was paid nearly $2.5 million in 2020, according to its tax filings with the IRS.

Burton continued, “We the patients will lose in either higher insurance bills or lower care from the hospital while the executives in both companies will continue to earn million dollar incomes.”


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