We are in negotiation with SUNY Upstate University Hospital to renew our relationship

We have been negotiating with SUNY over the past several months in an effort to renew our contract. If we are unable to reach an agreement, SUNY Upstate University Hospital will be out of network for the following UnitedHealthcare benefit plans, effective Jan. 1, 2023.

  • Medicare Advantage
  • UnitedHealthcare Community Plan, including our Dual Special Needs Plan (DSNP)
  • Employer-sponsored and individual plans
  • Veteran Affairs Community Care Network (VACCN)

However, as part of our effort to avoid disruption to care for the people we serve, we have agreed to apply a cooling-off period for SUNY Upstate University Hospital. This will ensure our members enrolled in our UnitedHealthcare Community Plan and UnitedHealthcare fully insured commercial plan have continued in-network access to SUNY through Feb. 28, 2023, while we continue discussions to renew our relationship.

Cooling off does not apply to DSNP, VACCN, Medicare Advantage or ASO commercial plans. If we are unable to reach an agreement, UnitedHealthcare members enrolled in these plans will no longer have in-network access to SUNY, beginning Jan. 1, 2023.

This negotiation does not impact our contract with Upstate University Medical Associates at Syracuse, the medical faculty practice affiliated with the hospital. Those physicians continue to remain in-network.

Our goal is to renew our relationship with SUNY so the people we serve have continued access to the important care the health system provides

We understand how disruptive it can be for our members if their hospital no longer participates in our network. But we also know that rising health care costs are putting pressure on family budgets and making it harder for people to afford the care they need.

On behalf of the people and employers we serve in Syracuse and the surrounding communities, please know we will stay at the negotiating table as long as it takes to reach an agreement. We hope SUNY will join us there and approach the negotiating table in good faith so that the people we serve have access to quality care that is affordable.

SUNY is demanding a significant price hike that would make the hospital one of the most expensive in all of New York for our UnitedHealthcare Medicare Advantage plan

SUNY is seeking a significant premium over the standard Medicare base rates that the majority of providers throughout New York and the country accept for our Medicare Advantage plans.

Agreeing to SUNY’s proposal would increase overall health care costs in the Syracuse market and would have a direct impact on the benefits we are able to provide seniors enrolled in our Medicare Advantage plan. We have made attempts to compromise and urge SUNY to do the same and provide a reasonable proposal that ensures the seniors we collectively serve have continued affordable access to its hospital.

SUNY has also proposed a 25% price hike over three years for our employer-sponsored and individual plans, which is not affordable or sustainable for Syracuse residents and employers

Health care costs continue to be a top concern for consumers and employers, and they expect us to make health care affordable. That’s especially true today, as businesses throughout the country struggle to attract and retain the employees they need. It’s more critical now than ever that we ensure they have access to affordable health care.

The unreasonable price hikes from SUNY would drive up premiums and out-of-pocket costs for the people we serve as well as the cost of doing business for both our self-insured and fully insured customers, impacting their ability to offer health care coverage for their employees.

SUNY’s 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. In Syracuse, the majority of our commercial members are enrolled in self-insured plans.

Agreeing to SUNY’s proposal would drive up health care costs for these businesses, resulting in them having less money available to pay competitive wages and to help grow the business through things like investments in new technologies.

Our top priority is ensuring the people we serve have access to the care they need and providing support to them and their families

UnitedHealthcare members will continue to have network access to high-quality care at St. Joseph’s Hospital Health Center, which continues to participate in our network in Syracuse.

UnitedHealthcare members in the middle of treatment for a serious condition at SUNY Upstate University Hospital may be eligible to continue receiving covered services for a period of time should SUNY leave our network. Examples of patients who may qualify include, but are not limited to, the following: 

  • Women who are pregnant and undergoing a course of treatment for the pregnancy from the provider or facility.
  • Patients with newly diagnosed or relapsed cancer or those currently in active cancer treatment. 
  • UnitedHealthcare members should call the number on their health plan ID card if they need assistance regarding continuity of care or help finding another hospital or physician that meets their health care needs.

In the event of an emergency, UnitedHealthcare members should continue going to the nearest hospital regardless of network status. Services will be covered at the in-network benefit level, regardless of whether the hospital participates in UnitedHealthcare’s network.