All Children's, United Healthcare contract renegotiations impacting patients

- Contract renegotiations between United Healthcare Insurance and All Children's Hospital in St. Pete is at a standstill - and the dispute leaves many patients stuck in the middle.

It all comes down to money. More specifically, how much the hospital is getting reimbursed for care.

With no agreement reached as of May 11, United Healthcare said services at All Children's Hospital are considered out-of-network. That equates to higher bills if patients want to stay there.

All Children's says they're just asking for a fair rate. United Healthcare says they've offered more money but it's not been accepted.

For parents and family of patients at All Children's, it's about much more than just money.

With bright blue eyes and curiosity well beyond her 13 months, Emerson Baker knows her hospital room all too well.

"It's our second home," Emerson's mother, Shannon Baker of Sarasota said. "Sometimes I feel like she thinks this is home."

Emerson was born six weeks premature and suffered unexpected birth defects.

"She had surgery less than 24 hours after she was born and she's had about eight surgeries since then," Baker said.

Emerson sees eight pediatric specialists at Johns Hopkins All Children's Hospital. Shannon said losing her daughter's care team is not an option.

"It's really not realistic for us to transfer her care to somewhere like Orlando or Gainesville and have to drive another two hours on top of what we already do and have to tell our story to them and have them reconnect with all the other physicians she uses," Baker said.

Emerson is just one of 10,000 pediatric patients the hospital says is being impacted by the contract renegotiation with United Healthcare. 

"Those negotiations are at a standstill, an extreme standstill. They have walked away from the table," said Dr. Jonathan Ellen, President and Vice Dean of All Children's Hospital

The hospital says they're just asking the provider "to pay a rate in line with what other insurance providers pay."

They've even taken the fight to 19 electronic billboards around the area.

"We are a not for profit and we do not make a profit. We take every dollar we make and reinvest it in our mission," Ellen said. "We would love to be able to talk about this so we can take care of all the children that want to come for care at our hospital but we are unable to do that."

United Healthcare said in a statement, “All Children’s is paid competitive rates that are in line with other specialty hospitals in the St. Petersburg area. Despite United Healthcare offering to increase their reimbursement rates by 20 percent, they continue to turn down our offers, insist on a 35 percent raise, and are deferring to an out-of-state consultant to manage the negotiation rather than working directly with our local team to reach a quick resolution.”

Baker says she and her daughter aren't going anywhere, whether that means paying more out of pocket or switching providers.

"There are kids out there who, this is their only option. They don't have the option to go somewhere else and it's just not fair to these kids," Baker said.

United Healthcare noted that other children's specialty hospitals at in-network, such as Children’s Medical Center at Tampa General Hospital, St. Joseph’s Children’s Hospital – Tampa and Shriners Hospital for Children – Tampa

United Healthcare said that any member in active treatment for a serious medical condition with an All Children’s physician may qualify for Continuity of Care, which enables them continued in-network coverage for their medical care at All Children’s. Applications are due by June 9. The provider said, for support in finding other in-network hospitals, members can call the customer care telephone number on the back of their medical ID cards or visit myuhc.com

All Children's Hospital said that hospital staff and physicians are working diligently and through extended hours to help families impacted by all of this. A special phone line is available for United patient families - 727-767-8284 or 1-800-456-4543 x78284. They've also encouraged employers and families to reach out to United by visiting HopkinsAllChildrens.org/United. 

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