Johns Hopkins, UnitedHealthcare end contract talks

Johns Hopkins Medicine and UnitedHealthcare have failed to reach common ground on a new contract agreement, and have called off talks after more than eight months of negotiations.

Starting Aug. 25, any provider or facility that is part of Johns Hopkins Medicine, except for Johns Hopkins All Children's Hospital in Florida, was considered out of network by UnitedHealthcare, Johns Hopkins said via statement. That means patients now have to pay out-of-network costs for seeing their providers, which typically costs more.

The organizations had negotiated past the original deadline, but were unable to strike a new deal, Johns Hopkins said.

"Our dedication to providing you with exceptional medical care has not changed," the health system said. "We will continue to work with you to navigate any insurance-related challenges to help you receive the care you need from your trusted Johns Hopkins team."

WHAT'S THE IMPACT 

Johns Hopkins and UnitedHealthcare were in negotiations for about eight months, and the health system accepted the insurer's request for an extension five times, the former said.

"Despite our best efforts, UnitedHealthcare refused to agree to reasonable contract language that prioritizes patient protections and access, instead insisting that we agree to terms that would make it difficult for us to provide care," said Johns Hopkins.

Specifically, the health system cited what it called "excessive" prior authorization requirements, frequent treatment denials, administrative burdens and delayed payments that forced the system to chase compensation.

The system encouraged patients to contact their employers to explore alternative insurance options during the open enrollment season.

While negotiations have ended, Johns Hopkins said it's still possible it could come to an agreement with UnitedHealthcare in the future, and return the insurer to in-network status. 

But as of right now, the system maintains that UnitedHealthcare is "unwilling to remove problematic language" from their contract that "allows them to continue to delay and deny care coverage."

It advised patients to ask UnitedHealthcare for continuity-of-care coverage by calling the numbers on the backs of their health insurance cards.

UnitedHealth care contends Johns Hopkins informed them on Sept. 15 that it was walking away from negotiations because the insurer would not agree to language that would allow them to turn employees and patients away from receiving care based on their own criteria and discretion.

"We were preparing to send a counter proposal on contract language later in the week. Johns Hopkins told us not to bother sending the proposal unless it included language that allowed them to have the right to terminate employers from receiving benefits and care at their health system," UnitedHealth said. "Johns Hopkins’ demands are unacceptable. We will not allow any health system to turn patients away at their discretion."

THE LARGER TREND 

UnitedHealth Group, the parent company of UnitedHealthcare, reported Q2 financials in July and revealed that it would be exiting certain Medicare Advantage plans.

Without giving details of which markets would be affected, UnitedHealthcare CEO Tim Noel said, “Additionally, and unfortunately, given these pressures, we have made the difficult decision to exit plans that currently serve over 600,000 members, primarily in less managed products such as PPO offerings.”

UHG surpassed expectations on revenue but once more missed the mark on profit. Profit was just $3.4 billion, down from the $4.2 billion the company recorded in 2024.

The struggles extended to subsidiary Optum, with Optum CEO Patrick Conway saying during UHG's earnings call that the company was $6.6 billion below expectations in earnings. Conway attributed this to a number of factors, including an accelerated medical cost trend, lower service volumes and an underestimation of new members' risk status.