UHC, Synapse delay to ‘accommodate onboarding’ 

YARMOUTH, Maine – UnitedHealthcare’s decision to delay the start date of its new capitated agreement with Synapse Health speaks to the complexity of shifting to an alternative delivery model. 

In an emailed statement to HME News, a spokesperson for Synapse Health said the decision was made to accommodate provider onboarding and training schedules.  

“The Synapse Health model is based on partnership, and our network is made up of the highest-quality provider partners, offering numerous DME options across all geographic service areas of both states,” the spokesperson stated. “Together, we will be mutually caring for our patients. Patient continuity of care and service are our highest priorities, and we are pleased that our robust network ensures continuity of care, and the vast majority of patients will see no change in their local provider.” 

UnitedHealthcare announced in July that the agreement, which impacts standard DME for Medicare Advantage plan members enrolled in HMO and PPO plans in Georgia and North Carolina, would go into effect Sept. 1 instead of Aug. 1. 

Provider Craig Rae says the requirements associated with the agreement, such as maintaining 24-hour on-call coverage seven days per week and responding to Synapse Health within 30 minutes of a call, including after normal business hours, are extremely burdensome, especially at the set reimbursement. 

“For small providers like me, there’s no possibility that we could staff ourselves to comply with these requirements,” said Craig Rae, president of Penrod Medical in Salisbury, S.C.  “It’s hard to believe that Synapse could sign a contract with UHC that they would provide these products and services and subsequently try to find a network of providers that would enable them to do so.” 

Provider Chad McCrickard says he hasn’t had much luck getting information about the process for transitioning his patients to a network provider. 

“I have been contacted by several different people stating different things,” said McCrickard, president of Petsch Respiratory Services in Martinez, Ga. “I tried to return an email by phone, gave the person my direct cell, to which they emailed and said, ‘I heard you have some questions for me, please let me know what they are so I can get them answered.’ That tells me they are in above their heads.” 

• Providers previously spoke out about the low reimbursement associated with participating in the agreement. 
• Synapse Health says ‘there’s something in this for everyone.’