Updated April 26, 2024
We are negotiating with MercyOne in an effort to reach an agreement that is affordable for Iowa and western Illinois residents and employers
We are negotiating with MercyOne to renew our relationship so the people we serve have continued access to the health system’s hospitals, facilities and physicians throughout Iowa and western Illinois. We have a responsibility to provide the people we serve with access to quality health care while also helping to contain rapidly rising health care costs. Our goal is to keep MercyOne in our network at rates that are affordable for our members and employers throughout Iowa and western Illinois.
If we’re unable to reach an agreement, MercyOne will be out of network for the following health plans, as of July 1, 2024:
Health System |
Impacted Health Plans |
States Impacted |
What’s Terming |
Mercy One |
Medicare Advantage (individual and Group Retiree) and Dual Special Needs Program (D-SNP) health plans |
Iowa, western Illinois |
Hospitals and facilities-only |
Mercy One – Genesis Health* |
Employer-sponsored/commercial, Medicare Advantage (individual and Group Retiree) and D-SNP health plans |
Iowa, western Illinois |
Hospitals, facilities and physicians |
* Genesis Medical Center – Aledo is not impacted by this negotiation and will remain in-network for all plan types.
MercyOne is demanding significant price hikes for our employer-sponsored and Medicare Advantage health plans that would increase health care costs by $76 million over the next three years
MercyOne’s proposed commercial price hike of nearly 20% would outpace medical care consumer price index (CPI) increases over the last five years. Medical care CPI increased by a combined 8% over the past three years (2020-2023) and by 15% over the past five years (2018-2023). The rate increases MercyOne is seeking would make the health system’s physicians 15% more expensive on average than those at similar health systems in Iowa.
Along with its commercial demands, MercyOne is also asking for Medicare Advantage price hikes that are significantly higher than the standard rates set by the Centers for Medicare and Medicaid Services (CMS). These demands would have a direct impact on the benefits and offerings we’re able to provide our Medicare Advantage members and would unnecessarily drive-up health costs.
We have proposed to reimburse MercyOne at rates similar to other providers in our Medicare Advantage network throughout Iowa and Illinois.
Throughout the negotiation, MercyOne has repeated these unsustainable demands, which would increase premiums and out-of-pocket costs for our members as well as the cost of doing business for companies that simply want to offer affordable health care coverage for their employees.
MercyOne’s rate demands would directly drive-up health care costs for self-insured employers. Nearly 65% of our commercial members in Iowa are enrolled in self-insured plans
Health care costs continue to be a top concern for consumers and employers, and they expect us to help in making health care more affordable. That’s especially true today, as businesses throughout Iowa and western Illinois struggle to keep their doors open and attract and retain the employees they need. It’s more critical now than ever that we ensure they have access to affordable health care.
MercyOne’s current proposal would directly drive up health care costs for our self-insured customers, given that these employers pay the cost of their employees’ medical bills themselves rather than relying on UnitedHealthcare to pay those claims. Nearly 65% of the people we serve in Iowa and Illinois are enrolled in employer-sponsored self-funded plans.
As the prices for health care continue to rise, these employers have less money available to help grow their business through things like investments in new technologies or increase salaries for their employees.
We have proposed a multi-year contract which includes a double-digit commercial rate increase that would ensure MercyOne continues to be reimbursed at market-competitive rates
In an effort to compromise in the spirit of good-faith negotiation, we have provided MercyOne a proposal that includes meaningful rate increases. Our latest proposal includes a double-digit commercial rate increase that would help ensure MercyOne continues to be reimbursed at market-competitive rates while helping to ensure health care remains affordable for the people and employers we serve throughout Iowa and western Illinois. Unfortunately, MercyOne continues to repeat its demands for unsustainable commercial price hikes of nearly 20% and significantly high Medicare Advantage rates.
We urge MercyOne to accept our latest proposal without further delay so the people and communities we serve can have access to care at an affordable cost
We recognize the relationship our members have with their providers is not only important, it’s personal. We assure you we do not take this potential disruption lightly. Our top priority is ensuring our members have access to the care they need while making health care affordable for them and the employers we serve. We urge MercyOne to finalize our latest proposal without further delay so that the people we collectively serve have continued access to the health system.