Our efforts to reach an agreement with Montefiore Health System

5 points to know about our negotiations

We continue our efforts to reach an agreement with Montefiore Health System for the benefit of the people and employers we mutually serve. While we have worked hard to try to move things forward with Montefiore, little progress has been made. As we continue to work through the negotiations, here are the top five things you need to know:

  1. Over the past three months, we have sent six proposals to Montefiore, which already has the highest commercial reimbursement rates of any health system in New York City. From Jan. 29 - Feb. 11, we sent two new proposals to Montefiore, each including significant compromises that would provide the health system meaningful increases to its reimbursement. 

  2. On December 31st, we proposed to Montefiore that we extend network access to our members to the health system’s hospitals and physicians through May 31, 2021. This would have ensured Montefiore was reimbursed at its prior reimbursement rates, which were the highest in New York City. Montefiore refused. We continue to propose to Montefiore that we restore network access through May 31. Montefiore continues to refuse our proposal.

  3. Over the past several months, we’ve had agreement on rates for our Medicaid plans that would exceed the state Medicaid rate. Montefiore refused our proposal to finalize the Medicaid contract unless we accepted its nearly 30% price hike demands for our employer-sponsored and individual plans, unnecessarily disrupting access for nearly 30,000 New Yorkers enrolled in our UnitedHealthcare Community Plan. 

  4. Throughout our negotiation, Montefiore has refused to make meaningful changes to its unreasonable demands for near double-digit annual rate increases. From its first proposal to now, Montefiore has moved from a 29% increase ($225 million impact) over three years to a 25.7% increase ($187 million impact). 

  5. While we continue our efforts to renew our relationship, our focus continues to be our members and ensuring they have access to the care they need at one of the dozen hospitals and nearly 7,000 physicians in our network in Bronx, Rockland and Westchester counties. We are also working closely with physicians and members to expedite all continuity of care (COC) requests so members with ongoing conditions such as cancer treatment and pregnancy can continue to receive uninterrupted care from their Montefiore provider.