ECU Health
Our goal is to renew our network relationship with ECU Health while providing families access to affordable care
We are actively negotiating with ECU Health to renew our network relationship following the health system’s decision to issue a notice to end our current contract.
We have a longstanding relationship with ECU Health. UnitedHealthcare and the UnitedHealth Foundation (UHF) have provided ECU Health multiple grants over the past few years as part of our collaborative efforts to improve the health and well-being of the people we serve throughout eastern North Carolina.
We want people to have continued access to ECU Health. However, we also have a responsibility to ensure that access is affordable. Health care costs are directly affected by the reimbursement we negotiate with health systems in our network. One of the leading drivers of rising health care costs are the prices hospitals charge, such as ECU Health.
Our goal during this negotiation is to reach a solution that continues to reimburse ECU Health appropriately so they can continue providing the quality care people rely on while not placing a burden on hard-working families and employers already struggling during challenging economic times.
As we continue our discussions with ECU Health, we want you to be aware of the potential impact of the health system’s demands on you and your family, as well as important information you need should ECU Health choose to leave our network.
ECU Health is demanding a near 60% price hike that would make it significantly higher cost than any health system in our commercial network in North Carolina
ECU Health has acquired providers over the years and become the market-dominant health system in eastern North Carolina, giving it significant influence over local health care costs.
The reimbursement ECU Health receives today is significantly higher than the average of all other health systems in our network in the state, and higher than the average reimbursement other peer academic health systems in North Carolina receive.
ECU Health is now using its market power presumably as leverage to pressure us to agree to significant price hikes that would drive up health care costs for people and employers throughout eastern North Carolina.
ECU Medical Center would be more than 65% higher than the average cost at all other academic medical centers in North Carolina by 2028 if we agreed to ECU Health’s demands
Agreeing to ECU Health’s proposed price hikes would mean it would cost approximately $24,000 more to deliver a baby at ECU Medical Center by 2028 compared to the average cost of all other academic medical centers in North Carolina. This would turn childbirth into a luxury service rather than a community benefit.
Common services like an MRI would cost $3,000 more than the average cost of all other academic medical centers in the state, while a CT scan would be $2,800 more. This is particularly impactful given people often need more than one of these scans, further compounding what they pay for these services.
ECU Health issued a notice to end our Medicare and Medicaid agreements with demands for significant rate increases for both plans, despite previously communicating these contracts were not an issue for the health system
We presume ECU Health took this step to use some of its most vulnerable patients as leverage to obtain the significant rate increases it is seeking for our commercial plans.
However, the health system is now proposing significant rate increases for both plans. Agreeing to this would make them among the most expensive in our Medicare Advantage network in North Carolina and would have a direct impact on the benefits the people we serve rely on.
The price hikes ECU Health is seeking for our Medicaid plans would make it the highest cost health system in our Medicaid network in the state. The states where we operate our Medicaid plans have asked us to support their efforts to provide quality health care coverage to their residents while also helping to contain rapidly rising health care costs. We take this responsibility seriously and are committed to being a good steward of taxpayer dollars.
Nearly 90% of ECU Health’s proposed price hikes for our commercial plans would be paid out of the budgets of self-insured employers
Most North Carolinians are enrolled in employer-sponsored commercial plans that are self-funded. That means the actual cost of health care services is directly paid by these employers, their employees, and their families, while we manage the administrative tasks on their behalf.
When hospitals demand steep price hikes, employers must make difficult decisions about benefits and costs. When provider costs rise, these employers bear the financial risk and often have no other choice than to pass those costs along to employees, resulting in higher deductibles, out-of-pocket expenses, and employee contributions.
Agreeing to ECU Health’s near 60% price hike demands would mean 10 employers would see their health care costs increase by $1 million or more each over the next three years. One business would experience an approximate $12.1 million increase, while two other companies would see their costs rise between $6.3 million to $6.5 million.
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 employees.