Patients could suffer if hospital, insurer don’t reach deal

Loyola Medicine is negotiating with a major commercial health insurer over reimbursement costs.

If a deal isn’t reached soon, some patients may face a tough decision: Pay more for medical care, if they can afford it, or be forced to find a new doctor.

For patients with complex conditions like Fanny Vlahos, leaving Loyola might not be an option.

Born with cystic fibrosis, she received a double lung transplant and was later treated for cancer.

UnitedHealthcare is her insurance provider. Loyola is her hospital.

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If a deal isn’t reached, Loyola’s doctors will no longer be in network for Vlahos and others with UnitedHealthcare insurance.

For her, that no deal is a big deal.

“All of my specialists are at Loyola,” Vlahos said.

Patients are not the only ones worried. Loyola’s Dr. William Small said he’s treated some of his cancer patients for more than 20 years.

There’s no way someone can be picked up with another provider, another physician and have that same level of care, that same level of comfort,” he said.

“I think it will cause a disruption for a lot of patients,” added Small.

Both sides say they want to reach a deal. But it hasn’t happened yet.

Loyola claims United hasn’t increased rates in more than two years, even though the for-profit company made more than $22 billion last year.

Meanwhile, United said Loyola’s parent company is seeking a 20 percent increase and is “threatening to create widespread disruption in health care in order to drive up costs to benefit its national organization’s bottom line.”

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Current Loyola patients are able to apply for what’s known as “continuity of care.” If granted it would allow them to pay the same in-network fees at Loyola. Vlahos said she recently received a 90-day extension under that program.

But if no deal is reached, she doesn’t know how long that would last.

“Those aren’t decisions that chronically ill patients should have to make,” she said.

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