Patients should benefit from insurance giant deal

The largest health insurance company in the United States has signed agreements with local physicians that should reduce out-of-pocket medical costs for about 5,000 Jackson County residents.

Effective May 1, most local physicians will become "in network" providers for UnitedHealthcare. Patients who see "in network" providers generally have lower co-payments than they have for "non-network" providers, those who have not signed contracts with their insurance company.

United signed agreements with PrimeCare, the independent physicians association for Jackson County. PrimeCare represents about 500 physicians, nurse practitioners and doctors of podiatric medicine.

Mike Bond, PrimeCare's chief executive officer, said people insured by United will generally see lower out-of-pocket costs, but the actual difference will depend on specific details in each individual's insurance.

"Their share of the bill should be less," Bond said, "but (the reduction) will depend entirely on the benefit plan their employer has negotiated with United."

While PrimeCare represents the vast majority of local physicians, Bond said some are not members, including those at Southern Oregon Orthopedics, Hematology/Oncology Associates, and Anesthesia Associates of Medford.

The agreements bring United back to Jackson County after an absence of about four years. Bond said PrimeCare terminated its contract in 2008 after physicians' offices said too many claims sent to United were processed improperly. Local providers also struggled with United's automated claim processing arrangements.

"We respect the corporate objective of achieving the lowest administrative cost through automation," Bond said. "However, providers in Southern Oregon are used to a more personal relationship with our contracted plan representatives, and that was not available at that time through United."

Bond said PrimeCare and United went through 18 to 20 months of "sometimes difficult" negotiations to reach an agreement. He said under the new agreement, United will assign a person who will have authority to fix problems if they develop.

United serves some 38 million people across the United States. It provides health insurance for many national companies that have employees in most or all of the 50 states, as well as large regional employers. It has contracts with more than 650,000 physicians and other health care providers, as well as some 5,500 hospitals.

United insures about 250,000 people in Oregon. Will Shanley, a company spokesman in Los Angeles, said United was "definitely excited" to re-establish its relationship with PrimeCare.

Bill Kettler is a freelance reporter. Reach him at

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