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UW contract evaluation under way

At Kaiser Permanente, we’re always working to deliver high-quality, affordable care for our members. We keep these goals in mind when we review contracts. That’s what we’ve been doing with UW Medicine. Our contract with them is set to expire on May 31, 2021. Over the past year, we have consistently communicated that the current contract does not provide the in-network affordability that we expect for the members we serve. We have not yet reached an agreement on a new contract, so we are notifying our members about the network change that will happen when the current contract ends.

For decades, Kaiser Permanente has had a trusted relationship with UW Medicine. We’ve worked together to care for patients through our 2 systems. Unfortunately, our ongoing work with UW Medicine isn’t reflected in the fees for services UW Medicine is requiring us to pay, which are nearly 20% higher than fees we pay to other health systems in the market. These costs have a direct effect on premiums. If we allow them to stand, they will reverse work we have done to keep rates stable for our members and employers.

The contract that expires on May 31, 2021, with UW Medicine includes care at UW Medicine hospital locations and with UW Physicians (UWP) providers.* If negotiations for a new contract are not complete by that date, we want you to understand how this will impact our members who have an HMO commercial or individual plan or a Medicare Advantage plan.

Seamless care for our members

We’re notifying all members who have received care at a UW Medicine hospital location or with a UWP provider within the last 12 months about this potential network change.

  • Members who have completed their care with UW Medicine hospitals or UWP providers don’t need to do anything.
  • Members who are currently authorized and scheduled for care with UW Medicine hospitals or UWP providers can continue with that care for the authorization period.
  • No care needs will go unmet. If additional services are needed beyond the authorization, members will be directed to Kaiser Permanente Washington resources and/or other providers available within our network.
  • If the contract is not renewed by May 31 and members choose to continue to see UW Medicine providers after May 31 without the authorizations outlined above, the cost of this care won’t be covered under their plan.
  • Access PPO members will continue to have access to UW facilities and providers through the First Choice Health Network.
  • UW emergency services will continue to be an in-network benefit. If additional services are needed following an emergency, members will be directed to Kaiser Permanente resources and/or other providers in our updated network.

Commitment to Affordability

Kaiser Permanente was founded on the belief that high-quality health care should be accessible and affordable to all. Now more than ever during this time of a global pandemic, we remain committed to this vision.

It is our intent to continue to work with UW Medicine on a new in-network provider contract that meets our expectations for high-quality care and affordability. If we’re able to achieve these goals in a new contract agreement, we’ll update you immediately.

 

*Locations that will be out-of-network will include UW Medical Center, UW Medical Center – Northwest, UW Neighborhood Clinics, University of Washington Physicians (UWP), UW School of Medicine, Harborview Medical Center, Valley Medical Center, and Valley Medical Group.

All plans offered and underwritten by Kaiser Foundation Health Plan of Washington or Kaiser Foundation Health Plan of Washington Options, Inc.

© 2021 Kaiser Foundation Health Plan of Washington