M Health Fairview says over 100,000 patients with commercial plans from UnitedHealthcare may find themselves out of network come Jan. 1, 2026.
Some on the plan received a letter from the health system this week.
UnitedHealthcare and Fairview are in a contract dispute. Those at risk of ending up out of network are on commercial plans, largely offered through employers.
“While families are struggling to afford skyrocketing health care costs, Fairview is demanding a more than 23% price hike for our commercial plans that would make it significantly more expensive than any health system in the Twin Cities,” a UnitedHealthcare spokesperson said in a statement to WCCO.
UnitedHealthcare says that 23% increase would cost consumers and employers $121 million dollars more, adding this price increase would directly impact self-insured employers.
Fairview says that increase would be stretched over three years and argues increases to rates over the past several years have been inadequate with costs driven by inflation, workforce shortages and the pandemic.
“We invite UnitedHealthcare to join us in finding a solution that prioritized patients and the care they deserve,” said Dr. Jaya Kumar, the chief medical officer of Fairview Health Services in a statement. “Unfortunately, UnitedHealthcare’s current commercial contract demands would force Fairview to make impossible choices — cutting services, limiting access — impacting our ability to deliver fully on our promise to our patients and communities.”
The two say they will remain at the negotiating table, trying to reach an agreement before the end of the year. UnitedHealthcare and Fairview ended another contract dispute centered on Medicare plans earlier this month. UnitedHealthcare says those on Medicare advantage plans will still have access to Fairview in network.
“There’s a lot of tension right now in the health care world,” said David Holt, a health care attorney in the Twin Cities.
Holt says pending changes at the federal level are part of the backdrop of this dispute, as Affordable Care Act premiums are set to change and Americans grapple with higher health insurance costs.
In Minnesota, health care made headlines for a different reason, as state officials are taking a closer look at some Medicaid services deemed to be “high risk” for fraud.
While admittedly Holt is a proponent of small healthcare providers, he says it can be a challenge to find specialized care anywhere as patients consider other options.
“Small providers, big providers [have] waitlists, especially when we’re talking about specialists,” Holt said. “It’s not easy and a provider does not have a, generally, a legal requirement for how long it is for you to be able to get in if they’re full.”
