Insurance company drops UMC for primary care

By Emily Richmond

Friday, Oct. 11, 2002 | 11:01 a.m.

Beginning next week, patients with Sierra Health Services insurance will have to pay their own way to see their primary care physicans at University Medical Center, hospital officials confirmed this morning.

The existing contract between UMC and Sierra Health expires Oct. 17, and the new deal does not cover primary care visits, said Kathy Silver, the assistant administrator of managed care and benefits for UMC.

The decision was a financial one, hospital officials said.

UMC is facing a budget shortfall of about $10 million, and the prior contract was not helping the bottom line, Silver said.

"We couldn't come to terms with Sierra on what was an equitable situation," Silver said. "I think Sierra understood our position and we certainly understand theirs."

Sierra Health officials could not be reached for comment.

There are about 14,000 patients using Sierra Health for treatment by county doctors. Beginning next week, those patients will either have to find new primary care physicians or pay the cost of the visits themselves.

Another 45,000 people in Clark County are members of Sierra Health's Senior Dimensions plan, which was also honored at UMC. Members of Sierra Health's Health Plan of Nevada will also be unable to use UMC doctors for primary care visits.

People will still be able to use UMC for emergency and urgent care services and be covered under their Sierra plans, Silver said.

UMC wanted Sierra to up its payments to be at least equal to what Medicare covers for senior patients, Silver said.

"What we were asking for wasn't even close to what was on the table," Silver said.