MOUNT VERNON — Tracy Phillips said she would have preferred to give birth at Knox Community Hospital, where she would have had her family near at hand, instead of Grant Medical Center in Columbus.
She is one of many local residents affected by the schism between Knox Community Hospital and United Healthcare. The contract between the two expired May 31, 2006; since then, KCH has been out of UHC’s network, which means patients with UHC are subject to higher healthcare costs if they seek care at KCH.
Phillips, a Mount Vernon resident with three children, said she had to change her childrens’ doctor to one in Utica, and had to drive weekly to her OB/GYN in Gahanna and to Grant Medical Center for her delivery.
“It meant a lot of extra driving,” she said. “It was definitely a strain. We’re on a budget, and rising gas prices certainly didn’t help.”
Phillips said she feels stuck; her husband works in Columbus and his employer does not offer any other health plan.
“I’ve not found any doctors in Mount Vernon that are willing to send my bloodwork elsewhere, so I’ve also had to change my primary care physician,” she said. “I’ve not found it difficult to get a doctor to accept my insurance, it’s just when they try to send lab work or order tests to be done at KCH, that’s when the problems arise.”
Phillips said she would love for both sides to come to an agreement.
Carla Devore of Mount Vernon, who also has UHC, said she thinks there are few doctorrs in town that will take UHC and, if they do, they work out of KCH and not other hospitals.
“My family does not have a family doctor as of now, which worries me should something come up,” she said.
Devore said she thinks the lack of a contract between UHC and KCH is hurting the community because of the large number of people who have insurance through UHC.
“It also hurts our local hospital because we are forced to go elsewhere,” Devore said. “Someone has to give in the negotiations somewhere.”
Bruce White, chief executive officer of KCH, said hospital officials continue to seek a final resolution and would like nothing better than to come to an agreement with UHC. He said the hospital’s major sticking point in the negotiations involves UHC’s rate of reimbursement, the amount of money the hospital receives for the care it provides.
White and former KCH chief executive officer Kevin Rogols have said repeatedly that UHC’s rate of reimbursement does not even cover the hospital’s cost for providing care.
“We’re not trying to be the victor,” said White. “We want a partnership that benefits both sides.”
White said the fact that both parties are still in negotiations is encouraging, but he does not want to be overly optimisitic at this point or give people in the community the idea that a renewed contract is just around the corner. He added that a consultant, hired by the hospital to help in the negotiations, has been helpful.
“I want to resolve the matter as expeditiously as possible,” White said. “The hospital is motivated to get this resolved because we know there are a number of people in the community who rely on UHC.”
The latest proposal contains a number of phrases and sections that require clarification, he said, and these ambiguities make it unclear what services are considered to be eligible charges and which are not. It could mean that a certain service is covered, White said, but UHC will exclude radiology and lab work, for instance.
He said he has received phone calls from some local employers who offer coverage through UHC, asking how the negotiations are going, adding that many are considering switching health insurance providers if the negotiations fail in the end. He said that, unfortunately, he cannot give a time line when the negotiations will end.
“I don’t want people to think we don’t care about people who have UHC,” he said. “I never want people to think that.”
White said any local resident in need of emergency care should come to KCH; they should not take the risk of driving to another community in an effort to save money. He said emergency care is considered to be in-network, even for people with UHC, and encourages anyone with questions about how their bills are handled to contact the hospital’s financial officers.
A United Healthcare spokeswoman did not return a phone call.
