Important Information about Oxford Relationship with Montefiore Health

I have copied a letter from Michael McGuire, CEO of UnitedHealthcare in New York. Unfortunately, the Montefiore Health system will no longer be considered in-network for all Oxford members. I will keep everyone updated if anything changes.

Despite months of hard work and repeated efforts to reach a compromise, we were unable to reach an agreement with Montefiore Health System. As a result, Montefiore's hospitals and physicians are now out of network for our employer-sponsored and individual plans, including Oxford, as well as our Medicaid plan, effective January 1, 2021. Consistent with state regulations, our members enrolled in fully insured commercial plans and our Medicaid plan will continue to have in-network access to Montefiore's hospitals until March 1, 2021. When it became clear that our ongoing discussions with Montefiore were not likely to lead to an agreement, we offered to allow our members to have network access to Montefiore's hospitals and physicians through May 31, 2021, while we continue our efforts to renew our relationship. Unfortunately, Montefiore refused, unnecessarily disrupting access to its hospitals and physicians for thousands of New Yorkers. Throughout our negotiation we worked hard to find a middle ground that balanced Montefiore's rate demands with the economic needs of the employer group customers and members we serve. We recognize that hospitals and doctors in New York City have been some of the hardest hit by the COVID-19 pandemic. That is why we sent multiple proposals that would have actually increased the rates we pay all of Montefiore's hospitals, despite its position as the most expensive health system in New York City. Unfortunately, little progress was made, largely because Montefiore refused to move off its demand of approximately 9% annual rate increases, which equated to a nearly 30% price hike over three years that would have increased health care costs by more than $200 million. Our primary focus at this time is ensuring that our members have uninterrupted access to the care they need and supporting them as they transition to new care providers. We know that network changes can be difficult, but our members can rest assured that they will continue to have access to high-quality, affordable care close to where they live and work.

  • Our network is one of the largest in the state of New York. We're privileged to have strong relationships with nearly 100 hospitals, 20,000 primary care physicians and 49,000 specialists throughout downstate New York, including nearly 7,000 physicians and a dozen hospitals in Westchester, Bronx and Rockland counties that are readily able to provide high-quality care that meets the needs of our members. Some hospitals remaining in our network in the area include Mount Sinai Health System, New York Presbyterian, Westchester Medical Center and NYC Health + Hospitals.

  • For our members who are actively undergoing treatment at a Montefiore facility or with a Montefiore physician, continuity of care provides continued in-network benefits for a period of time. Members should call the number on the back of their health plan ID card to see if they qualify.

  • We have updated our microsite — — to notify our members of Montefiore's decision to leave our network, and to ensure they have the information they need about alternative care providers as well as continuity of care.

  • Please refer to the enclosed communication for a list of neighboring network hospitals and details about when our members will lose in-network access, depending on their plan type.

I want to thank you for your patience during this difficult negotiation. We know many people we serve have developed personal relationships with Montefiore physicians, value having access to the health system and are rightfully concerned by this news. We assure you we remain open to continued conversations with Montefiore and are committed to restoring in-network access to the health system at rates that are more affordable for the companies and members we serve.

We value our relationship with you and will continue working hard on your behalf to achieve the goal of affordable health care for the New Yorkers we serve.

Michael McGuire

CEO of UnitedHealthcare in New York

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