Healthcare Contract Dispute Escalates in South Carolina
A critical contract dispute between Bon Secours, one of the largest healthcare providers in South Carolina’s Upstate region, and UnitedHealthcare has reached a stalemate. The negotiations, which have been ongoing for months, must be resolved by July to avoid leaving approximately 30,000 patients out-of-network. If an agreement isn’t reached, Bon Secours hospitals and doctors will become out-of-network for UnitedHealthcare insurance holders, potentially dramatically increasing healthcare costs for affected patients.
The dispute centers on Bon Secours’ demand for a nearly 32 percent rate increase over the next three years, which UnitedHealthcare claims is more than double the inflation-adjusted increase in medical care costs over the past three years. UnitedHealthcare argues that such an increase would make Bon Secours the most expensive provider in its South Carolina network, potentially raising costs by $43 million across three years. This, they claim, would drive up premiums and out-of-pocket costs for consumers and employers who sponsor health plans.
“Our priority is to reach an agreement that reflects the current healthcare environment and ensures we can continue providing the high-quality care our patients expect and deserve,” said Matt Caldwell, president of Bon Secours’ Greenville market, in a statement. Bon Secours maintains that UnitedHealthcare’s current reimbursement rates are “overwhelmingly inadequate” to cover the cost of providing quality care.
UnitedHealthcare disputes Bon Secours’ characterization of the negotiations, stating that they have met frequently with Bon Secours leadership in an attempt to reach an affordable agreement. “We need Bon Secours to share our commitment and sense of urgency to finalize a contract that South Carolina families and employers can afford,” a UnitedHealthcare spokesperson said.
The potential consequences of going out-of-network are significant. The average cost increases for patients if Bon Secours’ requested rate hike is implemented would be:
- Inpatient surgery: almost $11,000 increase on average
- Outpatient surgery: over $3,600 increase on average
- ER visit: more than $700 increase on average
- MRI: over $400 increase on average
Some patients will be partially protected from disruptions in their care, including pregnant individuals and those undergoing active cancer treatment, due to continuity of care provisions. However, for many patients, going out-of-network could result in significantly higher healthcare costs or reduced access to care.
Bon Secours operates over 130 locations in the Upstate region, with a significant presence in Greenville County and other areas. The contract dispute covers all contracts between Bon Secours and UnitedHealthcare, including commercial plans, Medicare Advantage, Exchange, and Veteran’s Affairs Community Care Network health plans.
In the event of a breakdown, UnitedHealthcare has advised its insurance holders to seek alternative in-network providers, such as Prisma Health, Spartanburg Regional Healthcare System, and AnMed. Bon Secours, meanwhile, has advised patients to explore alternative insurance options during open enrollment.
It’s worth noting that this is the second major healthcare contract dispute in the Upstate in two years, following a similar standoff between UnitedHealthcare and Prisma Health last year that affected approximately 58,000 patients. A retroactive deal was eventually reached with Prisma in July 2024, although some patients still faced higher bills from the out-of-network period.