Failed contract negotiations between Brown University Health and UnitedHealthcare mean that thousands of seniors and disabled residents will no longer be covered for non-emergency visits at four Rhode Island hospitals starting July 1.
Fallout from the closed-door dispute has spilled over into public communications, creating uncertainty for United Medicare Advantage plan participants over whether they can keep seeing Brown Health hospital physicians at the same cost even after the contract expires on Monday, June 30.
Brown Health on a webpage dedicated to the contract issue states that its hospitals — Rhode Island Hospital, Hasbro Children’s Hospital, The Miriam Hospital, and Newport Hospital — will be considered “out of network” for United Medicare Advantage patients. This would suggest that affected plan participants will have to pay out of pocket to keep seeing their same doctors, or even lose the chance to continue receiving non-emergency services.
But United on its own webpage calls out Brown Health for “inaccurate information” regarding the timing of loss of coverage. According to the health insurer, Brown Health physicians will remain “in network” for Medicare Advantage patients on and after July 1.
Jessica Wharton, a spokesperson for Brown Health, clarified in an emailed response Friday that hospital physicians will continue to participate in United’s Medicare Advantage plan through June 2026. However, out-of-pocket costs may rise for patients no longer in the network, depending on their plans, she said.
Amid confusion and a flood of questions to his office, Rhode Island Attorney General Peter Neronha has stepped in with a webpage of his own.
“Any sudden change in health insurance coverage can cause consumers to panic, and rightfully so,” Neronha said in a statement. “Affordable, accessible health care is foundational to our quality of life, and we hope this resource equips Rhode Islanders with the information they need, should they need it.”
Information on the number of inquiries from affected patients to Neronha’s office was not immediately available.
The AG’s website also addresses the question of whether UnitedHealthcare Medicare Advantage patients can keep seeing their Brown Health hospital doctors after July 1.
The answer, per the AG’s website: “It depends on your plan and your particular medical needs. You may need to pay more for care at Brown University Health hospitals if a contract is not agreed to, but you may still have some coverage for care provided at these facilities.”
The AG website refers readers to UnitedHealthcare’s website and phone number for more information on what’s covered under their individual insurance plans.
Negotiations break down over payments
Confusion over when coverage ends for affected participants tracks with the conflicting narratives each side gives. As United tells it, the hospital network made a “good-faith effort” to agree on new contract terms with Brown Health ahead of the June 30 expiration.
“Unfortunately, Brown University Health refused our proposal to extend our contract through the end of 2025 and is seeking to be paid significantly more than any health system in our Medicare Advantage network in Rhode Island,” the company states on its website.
United also said it offered to extend the existing Medicare Advantage contract through the end of 2025 as a stopgap until a longer-term agreement was worked out. Brown Health refused, “potentially and unnecessarily disrupting access to care for thousands of people enrolled in our Medicare Advantage plans,” the company states on its website.
Cole Manbeck, a spokesperson for United, did not directly answer questions about the miscommunication or how many plan participants will lose coverage at Brown Health hospitals.
“While we remain open to discussions with Brown University Health, our focus at this time is providing people access to the care they need through continuity of care or a smooth transition to another provider, as appropriate,” Manbeck said in an emailed statement Friday.
Brown Health maintains that the decision not to renew the contract was “mutual.” The hospital system said it wanted “fair reimbursement” and “less administrative burden for patients.”
Wharton pointed out that United offers higher reimbursements for the hospital network at its two Massachusetts hospitals than in Rhode Island, echoing the well-documented problem of the Ocean State’s uncompetitive reimbursement rates. The contract dispute does not apply to Brown Health’s Morton Hospital in Taunton or St. Anne’s Hospital in Fall River.
Federally reported data estimates 129,000 Rhode Islanders are enrolled in Medicare Advantage health insurance plans available for people 65 and older, or with disabilities or chronic conditions like end-stage kidney failure or ALS (also known as Lou Gehrig’s disease.) The commercial alternative to government-run traditional Medicare has grown in popularity nationwide and in Rhode Island with the promise of additional benefits and cost savings to participants. Participation in United’s Medicare Advantage program in Rhode Island grew 10.1% in 2023, according to the Rhode Island Office of the Health Insurance Commissioner’s (OHIC) 2025 annual report.
But private providers have faced increased scrutiny for inflating testing and diagnostics as a means to increase their bottom lines.
Research by the Center for Advancing Health Policy Through Research at the Brown University School of Public Health suggests Medicare Advantage plans are projected to receive $30 billion in additional payments this year as a result of “differential coding intensity” compared with traditional, government-run Medicare plans.
UnitedHealth Group Inc, the parent company for the insurer’s individual state plans, topped the list of private insurers raking in money through inflated risk assessments, spending an extra $11.6 million across its 6.9 million plan participants nationwide in 2025, according to the analysis, which is based on 2021 Medicare data adjusted to 2025 dollars. In Rhode Island, the insurer is projected to spend an extra $47 million due to higher risk assessments of its 37,000 plan participants this year, or $105 more per patient, on average. Blue Cross & Blue Shield of Rhode Island, which covers nearly twice the number of Medicare Advantage patients in the state as United, was projected to spend an extra $1 more per patient compared with traditional Medicare plan spending.
Both private insurers’ Medicare Advantage plans exceeded the state’s 6% cost growth target in 2023, with Blue Cross reporting a 7.1% increase in total spending, while United’s total costs rose 14.8%, according to OHIC’s annual report.
The end to the contract between Brown Health and United does not affect dual Medicare and Medicaid recipients. There are also assurances for continuity of care in certain cases, including patients with newly diagnosed or relapsed cancer, or those in active cancer treatment. United Medicare Advantage plan participants whose insurance is covered through a former employer under a group plan may also continue to receive care at Brown University hospitals.
This story was originally published by the Rhode Island Current.
