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Wednesday, October 07, 2009

Williamson Medical Center and United Healthcare

Several of you have asked about the latest in Williamson Medical Center's dispute with United Healthcare. For those of you who don't know, UHC dropped WMC from its network effective October 2nd. We have monitored this situation and communicated clearly with UHC regarding our concerns. We also continue to recommend that patients of physicians practicing out of WMC call their doctors and/or WMC administrators and encourage them to come to terms with UHC.

Network contract negotiations are not unusual, even though this type of hardball isn't common. This situation is the collision of two profit-minded monopolies. WMC is the only hospital or surgi center of any size in the Franklin/Cool Springs corridor. UHC is one of only five remaining multi-state health insurance conglomerates in the country. Both think the other needs them more and is waiting for the other guy to blink.

My sources tell me that both sides are still talking. That's good as it would be a loss for both companies and our people if negotiations broke down completely. The root of the conflict is money. WMC is asking for the highest network reimbursement rate of any hospital in the state of Tennessee. It believes UHC will blink because of the significant percentage of its patients that are health care decision makers (CEOs, CFOs, Presidents, etc...) for their companies. UHC believes that it has such a large share of the market that WMC can't operate profitably without their covered insureds (that's you).

We continue to monitor this situation and will let you know more as we know it. Meanwhile, for emergency care WMC is still considered in-network. Regardless, you should never pass up a hospital looking for an in-network hospital in case of emergency. For elective care you need to go elsewhere for now.

Jim

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