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Lehigh Valley Health Network (LVHN) announced Monday that it plans to cut ties with UnitedHealthcare insurance plans. The health system, which is part of Jefferson Health, said UnitedHealthcare’s “unfair payment practices” have led to delays and obstacles in the contract negotiations over the past two years. Why It Matters “We have worked tirelessly to reach a resolution with United[Healthcare], but they’re not interested in finding a fair solution for our patients,” the health system said in a statement. LVHN said UnitedHealthcare refuses to pay them “in accordance with the rates and expectations that were originally agreed upon.” Jefferson Health Chief Physician Executive and President of Jefferson Medical Group Dr. Edmund Pribitkin said this led to reimbursement that is 40 percent less than expected and is not a financially sustainable model. What To Know In a video address, Probitkin said UnitedHealthcare has offered solutions that are one-sided and would be detrimental to patients and providers and accused big insurers like UnitedHealthcare of taking advantage of regional and safety net health care providers. “As big insurers continue to report record profits, health systems are facing major financial issues and are forced to make difficult cuts in staff and services,” he said. “We have been trying to resolve this issue for years and can no longer sustain the losses caused by United’s actions.” As a result, LVHN has decided to terminate its contract with UnitedHealthcare unless the insurer works with Jefferson Health to remedy the LVHN reimbursement issues. Other providers in Jefferson Health’s network serving the Philadelphia metro area and surrounding counties will remain in network with UnitedHealthcare. Probitkin said Jefferson Health’s goal is to maintain an equitable relationship with UnitedHealthcare with fair reimbursement levels that will benefit patients and enable LVHN to continue providing the highest quality of care, regardless of insurer. In 2022, LVHN threatened to no longer accept Aetna insurance over reimbursement and delay of care concerns. But days later, the parties reached an agreement to keep Aetna members in network. In a statement to Newsweek, UnitedHealthcare said it delivered a proposal to LVHN in April and has yet to receive a counterproposal from the health system. The last proposal from LVHN, according to UnitedHealthcare, came in December 2024 and included “a near 30 percent hike” in the first year of the contract. “Lehigh Valley is making misleading and potentially false public statements about the status of our relationship in the middle of the Medicare Annual Enrollment period, presumably as a negotiating tactic,” a UnitedHealthcare spokesperson told Newsweek. “We ask Lehigh Valley to join us at the negotiating table and work toward an agreement that is affordable rather than using consumers as leverage to significantly drive up health care costs for Pennsylvanians and local companies.” What Happens Next If a new agreement is not reached, patients with UnitedHealthcare Medicare Advantage plans will not be covered as of January 25, 2026. Patients with commercial insurance plans will not be accepted on April 25, 2026. LVHN encourages UnitedHealthcare members to contact their insurer to learn more about coverage options. Newsweek has reached out to Lehigh Valley Health Network/Jefferson Health for comment. Have an announcement or news to share? Contact the Newsweek Health Care team at health.care@newsweek.com.
