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United, HCA rift not seen as crisis

Amid a money dispute, human resource managers expect patient care to go on.

By KRIS HUNDLEY
Published August 30, 2006

United HealthCare customers in the Tampa Bay area were concerned, but far from crisis mode on Wednesday after hearing that the insurer had been unable to reach a new contract with the nine HCA hospitals in the area.

Though the deadlock means the HCA hospitals are no longer part of the United network, veteran human resource managers said such disputes are generally resolved with time.

“We understand the parties are still trying to work toward an agreement,’’ said Allen Delprete, human resources manager for the city of Clearwater, which has about 1,900 employees insured through United.

“And we’re holding out hope that’s going to happen. But we’ll be prepared if it doesn’t. There are still plenty of hospitals available through the United network.’’

The impasse between the nation’s largest hospital chain and United, one of the country’s biggest insurers, came down to a dispute over reimbursement levels. United, which has about 500,000 members locally, issued a release criticizing “HCA’s demands for rate increases, year over year.’’

“Since HCA hospitals are already generally among the highest paid facilities in the state,’’ the letter said, “their demands would have placed an unacceptable financial burden on our customers and our members.’’

Earlier in the negotiations, an HCA executive had lobbied United’s customers for support by warning that the insurer’s proposed rates and terms “would eventually put this hospital in financial trouble.’’

HCA handled about 27 percent of the hospital discharges in the Tampa Bay area, according to the latest data compiled by the Florida Hospital Association. Its busiest local facility is Hillsborough’s Brandon Hospital, with 18,055 patient discharges for the 12 months ending September 30, 2005.

The busiest hospital in the area during the same period was St. Joseph’s in Tampa, with 44,500 discharges. St. Joseph’s is a non-HCA property that remains part of United’s network, along with 23 other hospitals.

Because United members will have access to HCA hospitals in an emergency and to an additional two dozen facilities for routine procedures, employers expect any disruption of services to be minimal. There are two possible exceptions.

Some employers said they had already heard from employees in south Hillsborough County, who were concerned because the closest hospitals are Brandon and South Bay, both HCA properties.

And in Pasco County, the Regional Medical Center Bayonet Point historically has been a major provider of cardiac care, though similar services are now offered at a cross-county competitor that remains in the United network, the former East Pasco Medical Center, now known as Florida Hospital Zephyrhills.

Kurt Conover, spokesman for HCA’s Bayonet Point, said the hospital has been working with United members who have previously scheduled surgical procedures. Some have been approved by the insurer, while others have not, he said. United said members should call the customer service number on their ID cards for assistance.

The muted response to the United-HCA battle may come from experience. For three months in late 2002, the seven hospitals of BayCare Health System were dropped from the Blue Cross and Blue Shield of Florida network after the parties were unable to reach an agreement.

In the interim, doctors and patients tended to simply postpone procedures, rather than go to a different hospital, said Amy Lovett, a BayCare spokeswoman. Another big source of patients — the emergency room — was unaffected by the contract deadlock.

“In all our hospitals, about 50 to 65 percent of our admissions come through the Emergency Department,’’ said Lovett, who assumes HCA hospitals have a similar admissions pattern. “So we think HCA will continue to see a large population of United patients.’’

Dr. Steven LeVine, a general surgeon in St. Petersburg, is affected by the battle between United and HCA on several fronts.

As an employer, he contracts with United to insure himself and his staff. But as a doctor practicing at HCA, as well as other local hospitals, he also receives reimbursements — which he describes as “terrible” —  from the insurer.

“I’m hoping HCA sticks by its guns,’’ LeVine said. “Then theoretically I’d pay more in premiums but I’d be getting more in reimbursements.’’

While the health care giants battle, LeVine expects few problems for either himself or his patients. He said non-HCA hospitals have plenty of beds and will be happy to have the business. And patients generally don’t care where they are treated, he added.

“Very few patients have loyalty to a hospital,’’ LeVine said. “They just don’t want to go to the last hospital they were at, no matter which one it was.’’

Kris Hundley can be reached at hundley@sptimes.com or (727) 892-2996.

[Last modified August 30, 2006, 21:03:58]