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Saint Joseph patients face higher costs in clash with insurer over reimbursement rates

Saint Joseph Mishawaka Medical Center, exteriors, Indiana Exterior photos of the Mishawaka Medical Center main entrance.
Saint Joseph Health System and UnitedHealthcare have failed to reach agreement on a contract setting the system's reimbursement rates with the insurer. Saint Joseph's patients have been out of United's network since Monday, July 1, meaning patients face significantly higher costs to stay with Saint Joseph.

Since Monday, Saint Joseph Health System patients who have health insurance with UnitedHealthcare face much higher prices, after St. Joe and United failed to reach agreement on their next contract.

Saint Joseph Health System says the change affects more than 6,000 of their patient households: Since July 1, its patients are no longer “in network,” meaning they face significantly higher costs.

Chris Karam is St. Joe’s president. He says the nonprofit Catholic system had been in talks with United, the nation’s fourth-largest health insurer, for eight months before the sides missed their deadline last week to reach a deal.

"At one point they even asked us to accept payment reductions," Karam said. "So as you can imagine, everybody listening and all of us have experienced the significant rise in the cost of everything, and they wanted us to go backwards — which we really struggled with for an organization, their parent company, United Health Group, they earned $22 billion in profits last year. I can't even put my mind around that kind of a number."

UnitedHealthcare declined our interview request but in a written statement said St. Joseph has demanded “price hikes that are not affordable or sustainable for the people and employers we serve throughout Indiana. We compromised and proposed meaningful rate increases that would have ensured Saint Joseph Health continued to be reimbursed at market-competitive rates.”

Patients who were already in treatment for chronic conditions like cancer can petition United to continue receiving in-network rates.

Parrott, a longtime public radio fan, comes to WVPE with about 25 years of journalism experience at newspapers in Indiana and Michigan, including 13 years at The South Bend Tribune. He and Kristi live in Granger and have two children currently attending Indiana University in Bloomington. In his free time he enjoys fixing up their home, following his favorite college and professional sports teams, and watching TV (yes that's an acceptable hobby).