Little boy gets to keep doctors thanks to agreement

TIPPECANOE CO., Ind. (WLFI) – IU Health and UnitedHealthcare have reached a contract agreement after months of negotiations. During that time of uncertainty, many families across the area worried about losing their doctor. Thursday’s announcement was a big relief for one family in particular who was concerned they would lose the only doctors their son has ever known.

“We were so excited because that meant we could keep these doctors!” exclaimed Andrea Gilkison.

Andrea’s five-year-old son, Oliver, spent the first three months of his life in ICU at Riley Hospital for Children in Indianapolis and nine months on life support at their home in Tippecanoe County for a rare disease.

“Oliver’s is Mitochondria Myopathy Complex 1 Deficiency. It’s a progressive and degenerative disease that’s neuromuscular,” said Gilkison.

Gilkison said during the first year, Oliver had to see several different doctors every other week. That has now changed to once every six months.

“I really don’t think we’d be where we are today without having those doctors in place,” said Gilkison.

Gilkison said because of the contract negotiations between IU Health and UnitedHealthcare, Oliver’s appointments at the beginning of this year were pushed back by two months. But the fear of losing their beloved doctors vanished Thursday,with the announcement of a new 2-year contract agreement.

The agreement allows 400,000 Indiana patients, like the Gilkisons, insured by UnitedHealthcare to access health care through IU Health.

IU Health Arnett CEO Al Gatmaitan said the new agreement means IU Health physicians and facilities are again in-network providers for UnitedHealthcare insurance plans. He said the negotiations centered around payment terms.

“If we don’t achieve a level in quality and service that we’ve agreed to, we won’t be paid the full amount. So, we’ve agreed to be accountable for quality, safety and service,” said Gatmaitan.

No matter what the hold up was, Gilkison said her family can now move forward.

“It’s very important that we stick with the same doctors, so that they can catch any kind of backslide or any kind of regression that he might be having,” said Gilkison.

Because they want to catch anything that would keep Oliver from being happy and healthy.

News 18 heard from one person insured by UnitedHealthcare who actually switched health care providers and a couple of others who were in the process.

A Franciscan St. Elizabeth Health spokeswoman said they have no immediate way to tally how many UnitedHealthcare patients they picked up during the negotiations.

blog comments powered by Disqus