EvergreenHealth & United Contract Negotiations
Patient FAQ
Following months of negotiations, EvergreenHealth and United Healthcare (United) have reached an agreement on a new contract, allowing EvergreenHealth to remain a participating provider in United's network.
For our United patients, this means that EvergreenHealth services, providers and locations will continue accepting United insurance products, and you will continue to receive coverage and benefits through your United plan. The agreement is retroactive to the date of the initial contract termination, so any services you received at EvergreenHealth on or after March 1, 2026, will be covered according to your United benefits plan.
We know that the uncertainty of the negotiation period and ultimately, the short period of termination has likely been stressful. That is why we are very pleased to announce this positive outcome, which upholds our unwavering commitment as a community-owned hospital to keep you—our patients—and those we serve top of mind.
Throughout negotiations, please know that EvergreenHealth strongly advocated to ensure our United patients retain access to their trusted EvergreenHealth doctors, and establish the expectation that insurance companies, like United, come to the table as fair and collaborative partners for the sake of our organization's viability for those depend on us.
These FAQs help provide you with background about why negotiations with United were necessary.
General EvergreenHealth and United Healthcare Questions
What does the contract between EvergreenHealth and United cover? What were you negotiating?
EvergreenHealth and United were negotiating a new contract that outlines the EvergreenHealth and EvergreenHealth Monroe services United insurance plans cover and the corresponding reimbursement rates that United pays to EvergreenHealth for providing patient care.
Due to recent changes in state law, EvergreenHealth was not allowed to notify you during the open enrollment period for most insurance plans during the fall of 2025. The new state regulations prevent care providers and insurance companies from announcing a potential contract termination until 45 days before the termination date.
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Why were EvergreenHealth and United negotiating their contract?
EvergreenHealth recognized the need to negotiate changes in our previous contract because the current cost of patient care was not aligned with the reimbursement EvergreenHealth receives from United.
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United Contract Questions
What are reimbursement rates?
The reimbursement rate is the amount of money an insurance company like United pays (or reimburses) a hospital like EvergreenHealth for the care and specific services that hospital and its staff provide a patient who has coverage through that particular insurance company.
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What do reimbursement rates have to do with my care?
If you have insurance and visit a hospital or doctor's office to receive care, the cost of your care is covered upfront by the hospital or physician's practice. The hospital or practice then submits a bill for the services you were provided to your insurance company. The insurance company then reimburses, or pays back, the hospital/doctor's office for the services and care you received.
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Are reimbursement rates based on the cost of care? How are reimbursement rates established?
How much your insurance company reimburses the hospital for services is based on each patient's insurance plan coverage as well as the reimbursement rates established in the contract between the hospital or practice and the insurance company. These reimbursement rates do not change immediately with the changing cost of care but are negotiated on an annual basis.
Insurance companies are allowed to negotiate different reimbursement rates with each hospital.
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Why are reimbursement rates lower than the cost of care?
Reimbursement rates are, in some cases, lower than the cost of care. United's reimbursement rates with EvergreenHealth were previously so low because the cost of care has been driven significantly higher over recent years by factors beyond our control, and United's rates do not coincide with rising costs for staff, pharmaceuticals, and supplies.
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What can happen if reimbursement rates remain low? What can happen if this kind of situation were to continue?
If a hospital like EvergreenHealth or EvergreenHealth Monroe is unable to successfully cover the cost of care, the hospital or affiliated outpatient practice is forced to make structural changes that could include pausing important services for our patients, among other things. Like any organization, even not-for-profit hospitals like EvergreenHealth must take in enough revenue to cover expenses.
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Our Commitment to You and Everyone We Serve
As a public hospital district, it is an inherent part of our mission to provide access to high-quality, high-value care for everyone we serve in our district. At EvergreenHealth, that means hiring top clinical experts and providing the best possible outcomes at an affordable cost – which is illustrated by our recognition from Healthgrades as a Top 50 hospital in clinical excellence, and our rank as second in the state by the Lown Institute for providing our community with a high value of care. Our sole priority is doing everything we can to support and improve the health and wellness of everyone in our community.
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