Saint Francis vs UnitedHealthcare comes at risk to local residents

Jon, then perhaps St Francis executives can explain why costs are vastly cheaper at Perry County Hospital for many of the same services. Perry County is also a non-urban provider so the excuse that it costs more than in urban areas doesn't hold water. Perry County didn't embark on a vast expansion of their physical plant that they could not afford. Just my two cents.

Jon - There are two sides to every story. St. Francis received an above the fold front page article. UnitedHealthcare received a staff writer's summation of their official release, in response to St. Francis' position, on page 3a. Publishing the entire release from UnitedHealthcare would balance the coverage and be informative to the consumers. KFVS chose to do just that.

https://www.kfvs12.com/2020/01/27/unitedhealthcare-released-statement-regarding-...

If you've published the complete response and I missed it I apologize.

And, Tim, thanks for understanding we were a little constrained here by the form of the news release.

"...too high for too long.." might be the most significant comment in the whole story. That alone has to flavor the faith you can put in St. Francis's argument. Look at how much money SFMC is throwing into advertising to support their position. How does that money affect the cost of patient care? Years ago, the STL Post ran a series of articles about how the cost of advertising added hundreds of dollars to the bed costs at St. Francis. Is this a SFMC money grab while crying "poor us!"?

Thanks for a thoughtful commentary, Jon. There is ”wrongdoing” and “rightdoing” on the part of Saint Francis. Mistakes have been made. What we need to remember however is that St Francis is still a very fine institution in this relatively moderate size community and we need this hospital and other regional hospitals to succeed if this community and whole area are to grow and prosper. Patients don’t need to overpay, but remember that United Healthcare is a monolithic 20,000 pound gorilla, and it’s throwing its weight around. Its executives are paid with the very grossly inflated profits of the insurance company, which far outweigh anything that many of the comments here are charging Saint Francis with. The insurance company is out for the insurance company, not for the insured and not for us in Southeast Missouri. Remember that. United Healthcare is a corporation and their goal is to make profits for their stockholders. They don’t care about the insured patient on an individual basis.It’s United Healthcare that should come back to the table, yet they don’t want to be perceived as the ones who blink. The victims however are the ones that are already insured with United Healthcare, who were duped into believing what hospital they could use, and United Healthcare is now changing those rules. It would behoove UHC to come back to the table since they are the ones that left, and to negotiate in fairness and good faith, and it would behoove employers to remember all of this when choosing their employees’ insurance next year.

Jon, there are plenty of patients, was just in there 2 weeks ago and patients were waiting all day to get a bed. They admit they have been overcharging all of us and now want us to come to their defense. That is laughable and anyone who helps them. Let the system right itself. Just go ask both hospitals about the flag pole measuring contests they had. Print that and the costs and see what people have to say then. Remember when both hospitals told us they had to merge or we would loose one of them. Over $650 million has been spent by both on expansions since. Your backing a lame horse bud! Even if they advertise with you.

S Aydt...so how are the St Francis executives paid since we brought that up? From donations? No. The Catholic church? No. From patients and their insurance providers. They have EVERY right to require St Francis to charge comparable prices to say Barnes in St Louis or Boone Hospital in Columbia, or to choose a facility that will. There is no doubt that the rank and file providers and care givers at St Francis are diligent, great people trying to do an excellent job. THEY are not the issue. It is the leadership, past and present, that got the hospital in this pickle. As I stated on another thread, there is a problem when people are defending an insurance company against a hospital. Even one with 'grossly inflated profits.'

How much is Saint Francis Healthcare paying the Southeast Missourian for all of this favorable reporting? The article posted on Facebook shows the article as a paid partnership...

Thomas, like most media organizations nowadays the Southeast Missourian advertising department provides marketers an option to run “Sponsored Content.” These are clearly marked on semissourian.com and in print when they run. Several hospitals in this market (including St. Louis' entities) have availed themselves of this option to share messages, which must meet certain quality thresholds. Southeast Missourian news articles are not sponsored (though we did have a sponsor for our Catfish baseball coverage last year, enabling us to dedicate more resources to it). Nor is my column sponsored.

As for favorable reporting, the news stories stand for themselves -- and independently report both sides' perspectives. As for my column, an opinion piece, let's review the basic sections: 1) Both entities are firing at each other with specific charges [neutral]; 2) Employers are caught in the middle, and some of those who recently renewed coverage to find that a hospital they had understood to be in-network might not be are upset [not my words; but reporting an anti-United perspective]; 3) United decries costs at Saint Francis and more [anti-Saint Francis]; 4) Saint Francis has honorable (and new) people working there who have identified pricing is an issue (pro- and con-Saint Francis]; 5) Non-urban hospitals have different cost challenges [neutral, reporting a study that is important for us to understand when comparing urban to non-urban pricing, but anti-United in that insurance company practices can threaten non-urban hospitals]; 6) Both entities have indicated a desire to negotiate [pro both sides]; 7) I wish “them both success in their efforts – to lower medical costs while providing important local options” [pro both sides; pro community].

As my headline indicates, this negotiation battle “comes at risk” to local residents on many levels: the viability of a hospital (which is an economic driver for the region and a provider of quality, local services); the pricing of medical services (which is too high in this region, led historically by Saint Francis); and the immediate challenge for those using Saint Francis facilities who might find themselves out-of-network soon in the middle of cancer treatment, pregnancies and more.

Other commentary -- the opinions and insights of all those reading -- is certainly welcomed, too, which is why semissourian.com provides this commentary service on our site. I hope this helps...

Actually, I’m shocked to read that St Francis and United had reached an agreement in the first place. I had UHC for years (until 2016) and StF didn’t accept United Healthcare. Had an auto accident (2013) and was taken to StF; insurance required me to be moved to SEHealth ASAP.

St Francis charges way to much for their services, I was in for less than four hours for outpatient surgery and the bill was over $27,000.00, that is ridiculous. United healthcare and other insurers need to hold them accountable.

The Big Spenders of St Francis Hospital have been exposed all the money is going to pay for the interest payments and the Care patients are getting is substandard. The Church needs to take back the Hospital and kick out the Top People that have put in Jeopardy Patients Healthcare. They are the carpetbaggers and until the Hospital goes underwater and asks the court NO other Hospital will take them over. Boonville Hospital Just closed early this month to much money going to the Banks to pay on loans.

As a healthcare advocate, I’ve been puzzled for years that the cost of hospital services in this area remains so excessive. While St. Francis is part of a larger problem, their tactic of bombarding the airwaves with expensive marketing and politicking has badly backfired. People clearly just don’t believe them when they claim they have lowered costs because plenty of data is available suggesting otherwise. Setting up United Healthcare as the villain in this has also backfired. Local media is caught in the middle because both St. Francis and Southeast are lucrative sources of advertising dollars. In the end, the elephant in the room, or Godzilla in this case, is the dangerous high cost of healthcare nationwide. No amount of rhetoric will fix that, and St. Francis can’t buy enough television time and printed media space to convince folks that what is so, isn’t so. They’d better come up with a different approach, and soon.

A person would be amazed to see the advertising budget for both of the Cape hospitals that only benefits those medias that are being flooded with their ads. Could not half of the advertising be of better use to the public in the form of lower costs at each hospital. United Health Care and St. Francis both needs to do the public a favor and get over their dispute and get back to the basics of providing for the public the best health care available.

Would be interesting to know how many people, like me, have subconsciously tuned out both hospitals ads, because they have saturated the market. It’s like someone who lives near train tracks doesn’t even hear them after a while.

I would think United Health Care would be legally responsible for keeping those who already have United coverage, who had the understanding that St. Frances was an in-network provider, until their individual contract came up for renewal.

Those insured by United should have been given a heads-up about this impending change much sooner or possibly United should continue in-network coverage for some grace period until the insured have a chance to change their health care coverage. It feels like the rug was pulled out from under our feet.

We have used St. Francis our entire lives. In this electronic age all of our medical records are easily accessible and sharable. It would be no small thing to be forced to use another facility.

And, shame on St. Francis, that we should have to be the victims of their overspending.

A Red Letter Communications representative was quoted in the article. On another social thread, I learned STF uses RLCfor media projects. I can't confirm this. However if there is any arrangement between RLC and STF, this article is less credible for me personally.

I was hoping that somewhere in all of this I would

be able to learn if my United healthcare policy would still be honored at Southeast hospital if United and St.francis are unable to come to an agreement,any official word on that,I feel like several in the area would have this question.

Good question Bruce. Everyone involved should be asking the same question. The question is who is in network and who is not. Last weekend I went to a walk-in clinic and asked if you take my insurance. The answer was a yes and I was treated timely and professionally. But, the clinic was not in my network, and I paid a little more up-front. You have to remember this has nothing to do with your doctors, nurses and all the services provide by a hospital, clinic, etc. United heathcare is putting St. Francis out of network not you as an individual policy holder. So the question is, is Southeast in-network?

Good question Bruce. Everyone involved should be asking the same question. The question is who is in network and who is not. Last weekend I went to a walk-in clinic and asked if you take my insurance. The answer was a yes and I was treated timely and professionally. But, the clinic was not in my network, and I paid a little more up-front. You have to remember this has nothing to do with your doctors, nurses and all the services provide by a hospital, clinic, etc. United heathcare is putting St. Francis out of network not you as an individual policy holder. So the question is, is Southeast in-network?

-- Posted by Charles Bertrand on Wed, Jan 29, 2020, at 2:44 PM

Yes it is. But this news story is about St. Francis. All it takes is for you to go to your online account and check ? Totally different stories.

In response to the question relative to SE Health and United being in their network, the answer is "YES." All SEHealth providers and facilities accept UnitedHealthCare plans and are in network.

Therealworld, sorry if I didn't understand the article or I gave it a different spin. In my opinion, the article is about the state of health care.

St. Francis could be in-network or out of network. I was not being critical of St. Francis, United, walk-in clinics, other health care facilities, doctors, nurses, etc.

Southeast Missouri is loaded with health care options. You have doctors that will take your insurance card, you pay up-front, they code the procedure, give it back to you and you file with your provider. That process has not worked for me because all procedures have been denied. In summary, if you are dealing with health care you better be a student of the game.

"Here’s wishing them both success in their efforts — to lower medical costs while providing important local options."

From HealthCare.gov:Affordable Care Act (ACA)The comprehensive health care reform law enacted in March 2010 (sometimes known as ACA, PPACA, or “Obamacare”).The law has 3 primary goals:Make affordable health insurance available to more people. The law provides consumers with subsidies (“premium tax credits”) that lower costs for households with incomes between 100% and 400% of the federal poverty level. Expand the Medicaid program to cover all adults with income below 138% of the federal poverty level. (Not all states have expanded their Medicaid programs.)Support innovative medical care delivery methods designed to lower the costs of health care generally.

As he so ironically threatened in 2009, “If you misrepresent what’s in this plan, we will call you out.”“If you like your health care plan, you’ll be able to keep your health care plan, period.”“[T]hat means that no matter how we reform health care, we will keep this promise to the American people: If you like your doctor, you will be able to keep your doctor, period.”“In an Obama administration, we’ll lower premiums by up to $2,500 for a typical family per year.”“[F]or the 85 and 90 percent of Americans who already have health insurance, this thing’s already happened. And their only impact is that their insurance is stronger, better and more secure than it was before. Full stop. That’s it. They don’t have to worry about anything else.”“[W]hatever ideas exist in terms of bending the cost curve and starting to reduce costs for families, businesses, and government, those elements are in this bill.”“I will sign a universal health care bill into law by the end of my first term as president that will cover every American.”“So this law means more choice, more competition, lower costs for millions of Americans.”

So how much have all sides been "handcuffed" from the get go? I call BS to those claiming irrelevance.

My sympathy goes to the individual and employee policy holders that will get in network choices curtailed. Your employer has been forced to "shop" annually (usually through broker) for "best" insurance deal on your behalf (or cut you loose).

Even with SEMO and P&G, SFHCS says this is only 5% of their revenue stream, but 20% reimbursement cuts unacceptable. I really noticed the date they started quality+/cost- advertising campaign relative to the time they would have started planning for 11/19 contract renewal negotiations with United.

Welcome to the near decade old quasi socialized healthcare world those of us live in who always bought our own policy or lost employer coverage.

The one way to assure continued failure here is to bring partisan politics into this discussion. The Godzilla in the room has always been the obscene cost of healthcare. It has been for decades, through many administrations. The fix is to get costs under control. Whether a plan is Democratic or Republican, whether it is called Obamacare, single payer, Medicare for all, private pay, health savings account Trumpcare or anything else, it doesn’t matter. Until the cost of healthcare is addressed, plans won’t work. And partisan rhetoric certainly won’t.