UnitedHealthcare cuts Envision from its provider network

UnitedHealthcare
UnitedHealthcare has pulled Envision from its provider network. (jetcityimage/Getty)

UnitedHealthcare is continuing a trend of pressuring physician staffing firms by cutting Envision Healthcare from its network.

Envision said in a statement that its clinicians would no longer be in-network for UnitedHealth plans as of Jan. 1. Envision boasts 25,000 clinicians working in hospitals across 45 states and D.C.

UnitedHealth and Envision have had a contentious relationship of late, dating back to 2018 rate negotiations in which the insurer claimed that Envision's rates were double the median, leading to the staffing firm accepting a 22% rate cut.

Envision said in the statement that UnitedHealthcare now argues its rates are three times the median and was demanding further rate cuts before removing the firm from its network entirely.

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Envision said it offered to meet UnitedHealth "more than halfway" on potential rate decreases before negotiations failed.

“Our health care workers risk their lives every day taking care of patients who are fighting for theirs. In the middle of all this, we have United, an insurance and financial services company, that will only keep us in their network if we cut our doctors’ pay. This is wrong. I don’t know what to conclude except United does not value doctors or patients,” said Doug Smith, M.D., president of Envision Physician Services, in a statement.

In response, UnitedHealthcare said Envision's high costs are not reflective of fair market rates and are driving up costs for its members.

The insurer said it presented a proposal to Envision in May to align rates more closely with other providers and that the staffing firm took two months to send a counterproposal that didn't address UnitedHealth's concerns about its rates. Negotiations continued through the end of December, United said.

“Most providers we work with are contracted at fair, market-competitive rates, but a small number of providers, and especially private equity-backed physician staffing companies like Envision, are driving up the cost of care for the people and customers we serve," the insurer said in a statement. "Envision expects to be paid nearly double the median rate we pay other anesthesiologists and more than triple the median rate we pay other ER physicians. While these egregiously high rates help meet the profit expectations of its private equity owner, they also make health care less affordable for people across the country.”

UnitedHealth has also similarly played hardball with TeamHealth, another physician staffing firm. UnitedHealthcare canceled its high-rate in-network contacts with TeamHealth in late 2019, and analysts said other insurers could take UnitedHealthcare's lead.