My next post on this blog was going to be about what to do if your doctor or health care provider leaves your carrier’s network. But KFF Health News beat me to it with an article appropriately titled, So Your Insurance Dropped Your Doctor. Now What?
Nationwide, contract disputes are common, with more than 650 hospitals having public spats with an insurer since 2021. They could become even more common as hospitals brace for about $1 trillion in cuts to federal health care spending prescribed by President Donald Trump’s signature legislation signed into law in July.
The article is well-written and covers the basics, but I do have a quibble with its item #2, when the article notes that rifts between hospitals and insurers often get repaired. It then goes on to state that most of those breakups ultimately get resolved within a month or two[.] So your doctors very well could end up back in the network after a split.
Historically, that’s not incorrect, but the recent Johns Hopkins/UnitedHealthcare and Memorial Healthcare/Florida Blue disputes both involved negotiating parties walking away from the table. The network contracts lapsed, and as of this writing, Johns Hopkins is still out-of-network with UnitedHealthcare and Memorial Healthcare is still out-of-network with Florida Blue. Some of the disputes I’ve picked up for the Network Contract Watch have included language suggesting more of this could happen.