Saint Joseph Health System Ousted From UnitedHealth System

Saint Joseph Health System is a not-for-profit Catholic health system operating mostly in Northern Indiana, along the Michigan border.  It serves many Southwest Michigan residents along this border.  SJHS is a subsidiary of Trinity Health, which is one of the largest U.S. healthcare providers, headquartered in Livonia, Michigan.

UnitedHealth is still recovering from the most expensive healthcare data hack in history. This hack imposed huge losses on all members of their systems and it is likely that Saint Joseph Health System attempted to recover some of those losses.  Trinity Health's Mercy Health System in West Michigan and Saint Joseph Mercy Health System in Ann Arbor do not seem to (yet) be affected.

We are likely to see more of these disputes, due both to the costs of these cyberattacks and the post COVID unprofitability of hospital operations:

https://www.leaderpub.com/2024/07/02/saint-joseph-health-system-removed-from-unitedhealthcare-network/

Saint Joseph Health System removed from UnitedHealthcare network

July 2, 2024

MISHAWAKA, Ind. — UnitedHealthcare has forced Saint Joseph Health System out of its network, effective July 1, impacting patients with UnitedHealthcare commercial, Medicare Advantage and Medicaid plans.

SJHS is a not-for-profit healthcare system located in North Central Indiana that offers acute-based hospital care and post-acute services including: community wellness, home care, physician clinics, outpatient services, independent and assisted senior living, memory care and affordable senior apartments. SJHS includes: Mishawaka Medical Center; Plymouth Medical Center; Outpatient services of the Elm Road Medical Campus; Health Insurance Services; Saint Joseph Medical Group; VNA Home Care; the Senior Living Communities at St. Paul’s, Holy Cross and Trinity Tower; and Saint Joseph PACE. SJHS serves more than 200,000 members of the Michiana community annually. SJHS is a Regional Health Ministry of Trinity Health in Livonia, Michigan.

“This outcome is deeply disappointing,” reads a statement from Saint Joseph Health System. “For more than six months, Saint Joseph Health System worked hard to reach a fair agreement that appropriately covers the true cost of care we provide. Our patients place incredible trust in us when choosing Saint Joseph Health System for their care. Please know we did everything within our power to protect their access and remain in network for care and services.

“Saint Joseph Health System relies on fair payment to provide the care and services patients depend on and need. Unfortunately, despite making billions, UnitedHealthcare chooses to propose increases far below market rates. We are a not-for-profit organization, which means the income we receive from every single dollar is invested back into our patients, communities, and employees so we can continue providing high-quality care to those we serve. Given the cost inflation and rising labor and supply costs we have experienced, we simply need a fair rate increase – we can no longer sustain low reimbursement.”

Saint Joseph Health System encourages patients to call UnitedHealthcare or ask their employer to let UnitedHealthcare know the importance of reinstating its in-network access to Saint Joseph Health System and its providers. Some patients may be eligible for in-network care for an extended length of time and should call the number on the back of their UnitedHealthcare card to determine coverage.

Patients can continue to find the latest updates by visiting sjmed.com/uhc or by calling (574) 404-8111.