One of the main issues facing Universal Health Services with regard to reimbursement is whether patients who may end up staying within the King of Prussia, Pa.-based health system for a few days are classified by payers as an inpatient or are simply under observation and therefore subject to different rates.
The status difference is one of the main examples of what UHS CEO Marc Miller described as "increasingly aggressive behavior" from insurers.
"We recognize the need to counter the increasingly aggressive behavior on the part of our payers and seek appropriate price increases to offset the impact of inflation on our cost structure and to seek further contractual protection to ensure we are properly reimbursed for the level of care provided to our patients," he said on an Oct. 26 conference call to discuss third-quarter financial results.
His words were supported by CFO Steve Filton, who said patient status disputes were a major issue for the system.
"We note that managed care behavior has become more aggressive in 2023 as it relates to denials and patient status classification changes," he said. "This is frustrating for us because a lot of these patients are in the hospital for multiple days."
The comments come on the back of related ones made by UHS following second-quarter results when the system admitted it cherry picks behavioral health patients based on an insurer's willingness to pay better reimbursement levels.
UHS reported net income of $167 million for the third quarter on revenue of $3.6 billion.