UnitedHealthcare and Fairview strike a deal for Medicare Advantage patients

Fairview and UnitedHealthcare have a reached a contract that will allow Medicare Advantage patients covered by the nation’s largest health insurer to keep seeing their doctors at one of Minnesota’s most prominent networks of hospitals and clinics.

The one-year deal, which the parties disclosed Tuesday to the Minnesota Star Tribune, comes nearly two weeks after Minneapolis-based Fairview Health Services began alerting patients about a contract impasse that could have blocked access to the health system for about 33,000 Medicare Advantage beneficiaries next year.

Open enrollment for 2026 Medicare health plans is ongoing and ends Dec. 7.

The dispute highlighted allegations that UnitedHealthcare has high rates of insurance payment denials — a charge the company has consistently denied in contract impasses over the past year.

Fairview claimed UnitedHealthcare imposes significant costs on the health system via claims denials and burdensome prior authorization requirements. UnitedHealthcare defended its record and administrative practices, insisting Fairview was making false claims while using its patients as a bargaining chip.

Without the agreement announced Tuesday, seniors during the current open enrollment season would have had to choose between switching Medicare Advantage plans and finding new health care providers.

“We reached this decision in the interest of stability for Minnesota seniors, even as we continue to have concerns about UnitedHealthcare’s approach to partnership and long-term sustainability in this market,” Fairview said in a statement.

“We’re pleased that Fairview Health signed the deal we’d previously agreed to,” Craig Stillman, the UnitedHealthcare Medicare CEO, said in a statement.

Fairview countered that the deal “is not the same proposal UnitedHealthcare had previously offered.”

Medicare Advantage is a private alternative to the government-run Medicare program. The plans feature low monthly costs and often include extra benefits for dental and vision care, but patients can face restrictions that steer them to smaller networks of doctors and hospitals. Original Medicare, by contrast, gives access to almost all health care providers, but beneficiaries are encouraged to buy Medicare Supplement policies, despite higher monthly costs, to avoid significant financial gaps with the coverage.

About 653,000 Minnesotans use Medicare Advantage plans offered by half a dozen different private health insurers.

The Fairview-UnitedHealthcare contract fight extended a trend of hospitals across the country balking at what they call unfair reimbursement rates and exasperating payment delays from Medicare Advantage health insurers.

Previously in October, Mayo Clinic in Rochester confirmed it would go out-of-network next year for most Medicare Advantage plans from UnitedHealthcare and Humana, a Kentucky-based health insurer.

Meanwhile, a contract dispute continues between Blue Cross and Blue Shield of Minnesota and Aspirus Health, which runs the second-largest hospital in Duluth. The impasse, which first surfaced in August, means about 60,000 patients could lose in-network access to Aspirus facilities in northeast Minnesota next year.

Wisconsin-based Aspirus Health operates St. Luke’s Hospital in Duluth and Lake View Hospital in Two Harbors.

“Under our current agreement with [Blue Cross of Minnesota], Aspirus St. Luke’s is significantly underpaid compared to other health systems in the Duluth market,” the health system wrote in a letter to patients last month.

Fairview, which owns University of Minnesota Medical Center, jointly markets hospital and clinic services with the U under the brand M Health Fairview. It is one of the state’s largest nonprofit groups, with more than 80 clinics and nine hospitals

Enrollment in the plans has steadily grown over the past two decades, but UnitedHealthcare is projecting its business will shrink by 1 million people next year amid cost pressures.

While Fairview and UnitedHealthcare have come to terms, the Medicare Advantage market continues to be turbulent due to premium increases, vanishing choices and bigger spending requirements when seniors use health care next year.