An update regarding our negotiation with Northeast Georgia Health System
More than 30 months have passed since Northeast Georgia Health System (NGHS) left our network following its demands to be paid significantly more than any health system in Georgia. We are writing today to share an update regarding our efforts to reach an agreement that’s affordable for Georgia families and employers.
We delivered a proposal to NGHS on Nov. 10 as part of good-faith efforts to move our negotiation forward. Rather than finalizing the terms of our proposal or providing a counter, NGHS has instead informed us that our negotiation is not a current priority.
The last proposal we received from NGHS would make it significantly higher cost than any other hospital in the state. Consider the following:
- NGHS’ demands would make it 34% more expensive than the average cost of the other hospitals ranked in the top 10 of U.S. News & World Report’s rankings for top hospitals in Georgia.
- NGHS’ hospitals would be more than 20% higher cost than the next-most expensive hospital in the state.
Rather than working with us to reach an agreement that’s affordable for Georgians, NGHS is seeking higher price hikes now than at any point during our negotiation.
Since going out of network, NGHS has more than tripled its prior rate demands for its physicians. NGHS’ latest proposal represents a more than 50% price hike on average for all of its physicians in the first year of our contract, and would make them significantly higher cost than all other physician groups in our network in the state. This includes demands for a 115% price hike for Longstreet Clinic – which NGHS recently announced it is acquiring – and has since issued a notice to end our network relationship, effective March 4, 2026.
This is yet another example of how NGHS has used its market dominance to acquire providers and drive up health care costs for consumers and local companies at an unsustainable rate.
We are committed to continued good-faith negotiation. However, we need NGHS to join us at the negotiating table and provide a realistic proposal Georgia families and employers can afford.
Standing firm against unaffordable price hikes
It remains our top priority to reach an agreement with NGHS that restores network access to the health system at costs that are affordable for Georgians and employers. We have made meaningful movement and compromises in each of our proposals as part of good-faith negotiation designed to reach an agreement. All of our proposals would ensure NGHS is reimbursed at rates that are more than fair and reasonable.
Unfortunately, minimal progress has been made in the nearly eight months since NGHS chose to leave our network. NGHS’ latest proposal actually moved our organizations farther apart. NGHS is seeking an approximate 25% price hike that would take effect over the first 24 months of our contract, including demands for a near 14% rate increase in year one that would make its hospitals the most expensive in Georgia.
NGHS is also demanding that we make the contract retroactive to May 1, which would lead to a significant amount of money coming from the operating budgets of employers who would be unexpectedly hit with additional costs.
Please know we do not take this disruption in the market lightly and remain fully committed to continued good-faith negotiation with NGHS. However, NGHS must join us at the negotiating table and work to find a reasonable solution Georgians and employers can afford rather than repeating its demands for unsustainable price hikes.
Please note: NGHS has stated on its website that people enrolled in the UnitedHealthcare Group Medicare Advantage National PPO plan, including the Medicare Advantage State Health Benefit Plan for retirees, are not impacted by this negotiation. People enrolled in this plan will continue to have access to NGHS’ hospitals and physicians.
NGHS is demanding a near 25% price hike over that would take effect over the next 24 months, including a double-digit rate increase in the first year that would make its hospitals the most expensive in Georgia.
NGHS’ demands are not affordable or sustainable and would drive up premiums and out-of-pocket costs for Georgians as well as the cost of doing business for both self-insured and fully insured companies, impacting their ability to offer health care coverage for their employees.
Agreeing to NGHS’ demands would mean one of our self-funded customers would see their health care costs increase by more than $3.5 million, while several others would see increases of more than $380,000 to nearly $540,000 over the next three years.
NGHS’ rate demands 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 Georgia, more than 70% of our commercial members are enrolled in self-insured plans.
NGHS’ proposal for egregious price hikes when its hospitals are already charging exorbitantly high rates would impact many businesses’ ability to continue offering affordable health care coverage for their employees. It would also mean they have less money available to pay competitive wages and to help grow the business through things like investments in new technologies.
The cost of care at NGHS’ hospitals is 47% higher than the average cost of hospitals in our network throughout northern Georgia. NGHS is also an outlier when compared to hospitals throughout the state.
The cost of a surgery at NGHS is 29% higher than the state average, while radiology services are 35% more expensive at NGHS compared to the state average of hospitals participating in our network.
NGHS charges egregiously high rates even for common services, tests and surgeries when compared to its peers. Consider the following examples:
- The cost of an MRI at an NGHS hospital is 2 ½ times higher – or approximately $1,600 more – than it would cost on average to receive the same test at another hospital participating in our network in north Georgia.
- The cost to receive a CT scan at NGHS is nearly $1,400 more than the average cost at other hospitals throughout north Georgia.
- The average cost of an outpatient surgery at an NGHS hospital is nearly $11,000 more than the average cost at peer hospitals throughout north Georgia.
- The cost of an emergency room visit at NGHS is approximately $1,500 more – or 65% higher – when compared to the cost at hospitals in north Georgia, and 42% higher when compared to the state average.
We remain committed to good-faith negotiation with the goal of reaching an agreement that is affordable for the Georgians and employers we serve
We know many people have developed personal relationships with their NGHS physician, value having access to the health system and are rightfully concerned by this news. Please know we remain committed to continued discussions with NGHS. However, we need the health system to join us at the negotiating table and work with us to find a solution that is affordable for the businesses and people we serve.