Premier Health, UnitedHealthcare have contract deal

Published: Tuesday, January 02, 2018 @ 1:50 PM

Premier and UntiedHealthcare have a contract as of Jan. 1, 2018.

Premier Health and UnitedHealthcare have agreed to a new contract, ending a seven-month dispute that affected nearly 200,000 health insurance policy holders in the region.

The two companies were unable to reach a new contract deal last May and the dispute dragged on through the end of 2017, leaving patients with Premier doctors and UHC insurance scrambling to either find a new doctor, switch insurers or pay more for out-of-network care.

“We are very happy to have found common ground and a way that Premier Health and UnitedHealthcare can work collaboratively to extend quality, patient-centered care in our communities,” said Mary Boosalis, president and CEO, Premier Health. “We look forward to working with UnitedHealthcare to continue serving our community and having a positive impact for its members who live and work in our service area.”


• No deal in sight between Premier and UnitedHealthcare contract talks

• Timeline: How Premier, UHC dispute unfolded in 2017

• Why the Premier-UHC dispute could hit region harder in 2018

The new contract deal was announced Tuesday and became effective immediately.

“Our priority is ensuring the people we serve have access to quality, cost effective health care,” said Kurt Lewis, CEO of UnitedHealthcare of Ohio. “Premier Health is an important community provider and partner and we are pleased to renew our relationship on behalf of the tens of thousands of people we serve across southwest Ohio.”

Details of the contract were not available but it was described as a multi-year deal.

Last year, both sides said the dispute centered around the giant insurer’s plan to rank hospitals and doctors in tiers based on cost and quality, with the stated goal of lowering the cost of health care by prompting patients to shop for cheaper care.

Premier opposed the ranking system, which it said is already steering patients away from its services and doesn’t accurately compare cost differences between its providers and other options.

Boosalis on Tuesday would not say whether tiering was a part of the new deal and said the fine details are still being hammered out.
RELATED: Sale of Premier Health's insurance line falls apart

“I am not able to talk about the specifics of the contract. That’s part of the agreement,” she said.

She said however, that she and her board feel good about the results.

It would have been easy to get a short term deal that wasn’t in the long-term best interest of patients, Boosalis said, but said she and her board pushed for the better long-term deal.

“It was hard for any given person on any given day and I don’t think I’ll ever forget that, but we had to look at the longer term and the greater good and that’s where we landed in the end,” Boosalis said.

The contract dispute hit the region hard leaving those in the area covered by UHC out of network at Premier, the largest hospital and doctor network in Southwest Ohio.

“It was very difficult and it was very serious and I don’t take that lightly and nor does my board,” she said.

Premier’s hospitals include Miami Valley Hospital with an additional location at Miami Valley Hospital South, Atrium Medical Center, Upper Valley Medical Center and Good Samaritan Hospital. Miami Valley Hospital operates the only Level I trauma center in the region, which has the highest level of comprehensive trauma care.

Being out of contract chipped away at both parties. Premier Health said previously that its bottom line was off by “millions” because of UHC patients having their access curbed and UHC was challenged this open enrollment season with selling insurance policies that at the time couldn’t be used in-network at the largest health care provider in the region.

RELATED: High Medicaid, Medicare use in Dayton increases health care costs

Temporary agreements would have expired this month that had been letting patients with UHC pay Premier doctors with a $25 co-pay and let UHC-managed Medicare Advantage plans remain in-network with Premier.

UHC has 200,000 policy holders in the area and as of May, about 70,000 UHC-policy holders had used Premier services over the past 12 months.

Open enrollment season is over for both commercial and government insurance plans for 2018, and some Medicare Advantage policy holders and employers have already switched insurance carriers because of the uncertainty.

Dayton Public Schools, one of the largest local employers covered by UHC, switched to Anthem for 2018, in part so employees with Premier could still see their doctor.

Trending - Most Read Stories

Go ahead and walk on this: Dayton’s newest street art project

Published: Thursday, April 19, 2018 @ 6:02 AM

            Street art
Street art

Dayton’s newest art public project has hit the pavement.

Words of wisdom, positivity and clever encouragement can be found underfoot on sidewalks across Dayton.

One message, placed near East Third and South St. Clair streets, advises, “Do what you love, love what you do.”

RELATED: Dayton Arcade’s sleeping giant: Art grabs attention, points to future

Another, near Twist Cupcakery, says, “Be a cupcake in a world of muffins.”

Outside of the Neon movie theater, passersby are told, “You are a star!”

The words on the street are brought to you by young artists from the HAALO program.

The acronym stands for Helping Adolescents Achieve Long-term Objectives, and is a partnership between Montgomery County Juvenile Court and the K12 Gallery & TEJAS.

TRENDING: Kitchen fire will close Brunch Club restaurant until weekend, owner says

Young people are painting about 35 inspirational and positive messages as part of a temporary art installation called Footsteps of Inspiration. About 15 of the affirmations have been installed and more are coming soon.

The art will remain for about 90 days — possibly longer — if the paint doesn’t fade.

“We’ve never had anything like this before,” said Brittini Long, community engagement coordinator with Montgomery County Juvenile Court.

RELATED: 10 murals that make buildings beautiful in downtown Dayton

HALLO youth, as well other artists, have made downtown Dayton a lot more colorful.

Since 2010, participants in the HAALO Program, aided by other artists, have helped create 25 murals throughout the city.

One of the newer murals is at West Third and Williams streets in the Wright Dunbar neighborhood, which highlights highlights the Dayton Region’s Walk of Fame.

The youth also produced 17 master replicas of famous artwork that adorn the side of some vacant buildings at East Third and Sears streets.

The Footsteps of Inspiration is expected to become an annual project.

Other art projects have similarly tried to liven up what could be otherwise drab elements of the urban landscape.

Nine of Dayton’s storm drains are now eye-catching reminders that water alone is supposed to go into the storm water system.

The Dayton Arcade now has a cartoonish sleeping giant covering the north entrance to the property.

Trending - Most Read Stories

Councilman apologizes for comments to Plush family amid calls for resignation

Published: Thursday, April 19, 2018 @ 4:49 AM

Cincinnati council member apologizes to Plush family

A Cincinnati councilman is apologizing for comments he made to Kyle Plush’s family while the county’s republican chairman has called for his resignation.

Democratic Cincinnati City Councilman Wendell Young implied Plush’s family may seek financial compensation for the teen’s death in a Tuesday special council meeting, saying, “But there’s no amount of money that’s going to make you happy.”

Kyle Plush suffocated in a van last week despite calling 911 twice.

>> RELATED: Family of Kyle Plush storms out of Cincinnati special council meeting

“The choice of words I used, while not intending to cause hurt, allowed them to misinterpret what I was trying to say,” Young said at Wednesday’s council meeting, according to our partners at WCPO. “My fault entirely.”

Alex Triantafilou, chairman of the Hamilton County Republican Party, called for Young’s resignation, according to WCPO.

>>RELATED: How did Cincinnati teen become trapped, suffocate in van seat?

“I was offended and hurt for the family,” Triantafilou said. “I think our community has been so affected by this tragedy, and to have an elected leader in government make remarks that were so cross and painful — I was sad. I was saddened by the whole thing.”

Young's colleagues on city council said the exchange was embarrassing. 

>> RELATED: Who was Kyle Plush? Community remembers teen crushed to death by van seat

"You have to be ultra-sensitive and supportive of the family, and he definitely missed the mark there," Republican Amy Murray said. "It was shocking to me." 

Democrat Tamaya Dennard also called it "shocking," while fellow Democrat Greg Landsman called it "awful." 

"I don't know how to explain it. It was a terrible, terrible thing," Landsman said. 

>> RELATED: ‘Tell my mom I love her if I die’, teen pleads as van seat fatally crushes him

Tim Burke, the county's Democratic Party chairman, told WCPO by phone that calls for Young's resignation were unjustified.

Trending - Most Read Stories

Local man wins $20,000 in popular ‘HQ Trivia’ game app 

Published: Thursday, April 19, 2018 @ 2:31 AM

Local man wins $20K from popular phone app

A Miamisburg man won $20,000 after recently playing the popular HQ Trivia game app on his phone.

OTHER LOCAL NEWS: Butler County, Cincinnati  shops offer deals for Record Store Day

Jason Varney answered 15 trivia questions correctly on the app that typically allows people, twice a day, to attempt to get 12 trivia questions right in efforts to win part of a $5,000 jackpot.

In Varney’s case, the prize amount went up to $250,000 as part of a marketing deal between the app and a movie. The increased prize money also called for an increase in the number of questions he had to answer, from 12 to 15.

“When I was getting past question 12, my heart was pumping out of my shirt. I could’t believe what was going. It was visibly beating through my shirt. It was incredible”, Varney said. 

>>WHIO Mobile Alerts

He said the $20,000 will allow him to fly to Florida to see his great grandmother, who is recovering from a heart procedure. 

Trending - Most Read Stories

40-plus cats euthanized after infection sweeps Tenn. animal shelter 

Published: Thursday, April 19, 2018 @ 4:15 AM

Animal lovers angry after 40-plus cats euthanized at Tenn shelter.

An animal shelter in Tennessee is defending its decision to euthanize more than 40 cats after an infection swept through the facility. 

>> Woman hospitalized after pet cat attacks 

According to WATE-TV, animal lovers became outraged after learning the Pets without Parents shelter, which was reported to be a “no-kill” facility, put down dozens of cats. 

After weeks of attempting to nurse close to 50 cats that became infected with upper respiratory infections back to health, the shelter said euthanization was their last resort and only option. 

“My heart is animals,” said Lory Souders, the shelter’s president. “I’ve tried to save as many as I can.”

Although a number of people in the community claim the shelter isn’t doing enough to properly care for the animals and prevent disease from spreading, Souders says the problem is overcrowding.

>> Cat rescued from tree near Hospice of Dayton

Pets Without Parents has a contract with the county and the city, and must accept all pets dropped off by animal control.

"We have had a situation here," Souders said. "We've been full for a long time."

Not only are they full, but they're well over capacity. The facility is built to house around 150 pets, and it's now holding more than 200.

Despite the overcrowded challenges, Souders said the only time they euthanize is when animals are either too aggressive or too sick to find a new home.

What the facility really needs, according to Souders, is for more people to give shelter animals loving homes.

Souders hopes this unfortunate situation raises awareness about adopting and volunteering with animals. 

Trending - Most Read Stories