March 5, 2020
Letter to Saint Francis colleagues from Maryann Reese, President and Chief Executive Officer of Saint Francis Healthcare System
Dear Saint Francis Family –
I am disheartened to share with you that Saint Francis Healthcare System facilities are no longer in-network with UnitedHealthcare. As it stands today, Saint Francis physicians remain in-network.
While negotiations have continued over the past few months, we made little progress. United is unwilling to recognize the price reductions our colleagues have consistently implemented over the past two years. United is also intent on tiering Saint Francis as a more expensive healthcare option and steering patients away from our objectively high-quality, region-leading care.
If we were to accept the contract proposed by United, we would be forced to end service lines and lay off colleagues. I refuse to do either. For this reason, we did not reach an agreement with United.
It is a privilege to lead the largest company in southeast Missouri. Entrusted to me are more than 3000 colleagues and their families’ livelihoods. Thank you for trusting me with this responsibility.
As always, I look forward to the good yet to be for Saint Francis Healthcare System.
Dr. Maryann Reese
President and Chief Executive Officer
February 9, 2020
Letter to the Editor of the Southeast Missourian newspaper by Maryann Reese, President and Chief Executive Officer of Saint Francis Healthcare System
To the Editor –
After becoming President and Chief Executive Officer in the fall of 2017, many told me prices at Saint Francis Healthcare System were too high. We consulted with an independent company to perform a pricing study of Saint Francis compared to hospitals and health systems in St. Louis and the surrounding region. The results showed Saint Francis had work to do.
Even though our contracts with insurance companies allow for annual price increases, we voluntarily froze prices starting in 2018. In January 2019, we decreased prices by 15 percent. In January 2020, we decreased prices by another 10 percent. Our price freeze and those price reductions amount to more than $30 million in savings for all insurance companies and $10.5 million specifically for UnitedHealthcare.
In negotiations, I expected United to acknowledge our price reductions, and to extend the savings to our patients and employers. Instead, United increased premiums for employers and ignored our $10.5 million price cut. The price cut ended up in United’s pocket whose profits totaled $9 billion for last quarter alone.
At the same time United was selling employers plans they said would include Saint Francis in-network, they were issuing Saint Francis a letter of termination. United terminated the contract while we were willing to continue negotiations. United even has a term for this tactic – “Terminate to Negotiate.” Using patients as pawns is the promise we believe was broken.
United wants $11.5 million cut from our prices. We have already cut $10.5 million. We did this before they asked. United needs to acknowledge the reductions already given. To provide an additional $11.5 million jeopardizes our ability to keep our doors open long-term.
In addition to price, Saint Francis is negotiating with United on tiering and steering of Saint Francis services. Tiering occurs when an employer decides to include Saint Francis in their insurance plan, but at a different level with higher premiums, deductibles and out-of-pocket expenses for employees. We say, “Saint Francis is now the high-quality, affordable option. Don’t tier us.”
Steering occurs during the pre-authorization process when an insurance company directs a patient away from services that are part of a physician’s plan of care to a lower cost and, many times, lower quality option. We object. Steering patients toward lower quality care options can increase the cost of care as tests and procedures must be repeated because of poor quality. We propose that if United wants to steer the patient to a lower cost option, then the quality must be equal to or better than Saint Francis.
Saint Francis is negotiating with United on three points. The first is price stability. We want United to agree that Saint Francis is appropriately priced, and has met the requested price concessions. Second, do not tier Saint Francis, as this does not make sense with our exceptional quality and affordable price. Lastly, do not steer patients to providers with quality standards less than Saint Francis.
It is a privilege to lead the largest company in southeast Missouri. Entrusted to me are more than 3000 employees and their families’ livelihoods. In addition, my responsibility as a healthcare CEO includes the health outcomes, experiences and costs of the communities we are called to serve. We set out on a multi-year journey to lower prices, and I am proud of the Saint Francis Family and our accomplishments.
We look forward to the good yet to be as we move forward in good faith negotiations with United. But, if an agreement cannot be reached, Saint Francis facilities will no longer be in-network with UnitedHealthcare beginning March 5, 2020.
Maryann Reese, RN, MHA, DHA, FACHE
February 7, 2020
Television station KFVS12 invited Saint Francis Healthcare System President and CEO Maryann Reese to share a guest editorial to discuss the Saint Francis perspective on current negotiations with UnitedHealthcare.
UnitedHealthcare Medicaid Members: Saint Francis Healthcare System’s current agreement with UnitedHealthcare Commercial and Medicaid products was terminated by United effective March 5, 2020. To continue receiving in-network care at Saint Francis, United Members should reenroll with one of the other two contracted MO HealthNet Managed Care Plans – Home State Health Plan and Missouri Care. All MO HealthNet Managed Care health plans are required to offer the same services and benefits.
MO HealthNet Managed Care health plan members can change their managed care plans for any reason during the first 90 days after becoming a managed care health plan member. Members can also change plans after 90 days for “just cause,” which includes but not limited to your primary care provider is no longer with your MO HealthNet Managed Care health plan and is in another MO HealthNet Managed Care health plan; or your specialist or other health care provider from whom you are currently getting services is no longer with your plan and is in another MO HealthNet Managed Care health plan.
Members can change health plans for MO HealthNet adopted or foster children any time. MO HealthNet children in State custody, getting adoption support or in foster care can change health plans as many times as circumstances necessitate. Foster parents will usually decide which health plan the foster child will have; however, sometimes the social services worker or the courts will choose the health plan for a child in State custody.
A member can make a change by contacting the Missouri Department of Social Services. If you have questions or would like more information about how to enroll in a new managed care health plan, call 1-800-348-6627.
January 31, 2020
Saint Francis Healthcare System continues to work with UnitedHealthcare in good faith negotiations. On Friday, January 31, Saint Francis met the negotiation deadline and sent a counterproposal to United. United will have three weeks to respond according to our agreement.
January 27, 2020
On November 6, 2019, UnitedHealthcare issued a termination notice to Saint Francis. On March 5, Saint Francis Medical Center will be out-of-network with United.
We are disappointed to share that United has chosen to put profits over patients by terminating its agreement with Saint Francis Medical Center, denying our neighbors across southeast Missouri in-network access to our nationally recognized care. United has created this disruption.
While other healthcare providers are raising prices, Saint Francis has gone against industry norms by lowering prices 25 percent since 2018. These price decreases are intended for our patients, and for our employers. United is benefiting from these price decreases and, instead of passing on the savings to employers, is increasing premiums while trying to tier and steer Saint Francis Healthcare System from United plans.