ALLENTOWN, Pa. — Lehigh Valley Health Network said Monday it will stop accepting UnitedHealthcare insurance from patients in 2026 if it can’t come to terms on a new contract.
The move affects thousands of LVHN patients at hospitals and offices in the Lehigh Valley — those properties that were providing care before Jefferson Health’s acquisition of LVHN last summer.
We have worked tirelessly to reach a resolution with United, but they're not interested in finding a fair solution for our patients."Jefferson Health in a statement
Jefferson Health has its own, separate agreement with UnitedHealthcare that existed prior to the two health systems joining forces in 2024.
In a statement, a spokesperson for UnitedHealthcare accused LVHN of making misleading statements as a negotiating tactic.
Since 2021, UnitedHealthcare has not paid at negotiated rates, which has led to reimbursement that’s 40 percent less than expected, said Dr. Edmund Pribitkin, Jefferson Health’s chief physician executive and president of Jefferson Medical Group.
“For more than two years, Lehigh Valley Health Network has been working with UnitedHealthcare to create a fairer relationship that better serves our patients,” Jefferson Health said in a statement Monday.
“Sadly, our efforts have been met with delays and obstacles as United continues its unfair payment practices.
“United refuses to pay LVHN in accordance with the rates and expectations that were originally agreed upon. We have worked tirelessly to reach a resolution with United, but they're not interested in finding a fair solution for our patients.
“As a result, we have made the decision to terminate LVHN’s contract with UnitedHealthcare unless UnitedHealthcare works with Jefferson Health to remedy the LVHN reimbursement issues.”
'Not financially sustainable'
“This model is not financially sustainable,” Pribitkin said in a recorded message posted online.
A UnitedHealthcare spokesperson said the insurer said it received notice Monday from LVHN of its intent to potentially end the contract.
"When reimbursement falls substantially below negotiated levels, it threatens our ability to fulfill our mission of providing exceptional care to all patients."Mark Whalen, executive vice president and enterprise chief strategy and transformation officer for Jefferson Health
The spokesperson said UnitedHealthcare made a proposal to LVHN in April and has yet to receive a counter proposal. LVHN’s last contract proposal was provided in December 2024 and included a nearly 30% price increase in the first year of the contract.
"Lehigh Valley is making misleading and potentially false public statements about the status of our relationship in the middle of the Medicare Annual Enrollment period presumably as a negotiating tactic," UnitedHealthcare said.
"We ask Lehigh Valley to join us at the negotiating table and work toward an agreement that is affordable rather than using consumers as leverage to significantly drive up health care costs for Pennsylvanians and local companies."
Mark Whalen, executive vice president and enterprise chief strategy and transformation officer for Jefferson Health, respodned: "The only thing misleading here is United Healthcare portraying this as a standard negotiation when, in fact, this is a direct result of United not abiding by the terms of the contract they agreed to.
"This ongoing dispute is caused by United Healthcare’s implementation of a multiyear 30% price decrease that was not agreed to, not accepted and is not sustainable. We have been actively attempting to resolve this issue for the past several years before issuing today’s termination notification."
Jefferson Health said the dropped coverage won’t begin until Jan. 25, 2026, for Medicare Advantage patients, and April 25 for commercial patients.
The health system recommends patients keep any scheduled treatments or appointments at LVHN until those times.
Whalen said in a prepared statement that LVHN is seeking a "fair agreement."
“Like all health systems, we are facing significant headwinds as costs rise faster than reimbursement," Whalen said. "Sustainable, fair payment is essential to maintaining access and quality for the communities we serve.
"When reimbursement falls substantially below negotiated levels, it threatens our ability to fulfill our mission of providing exceptional care to all patients.
“Our goal remains to reach a fair agreement with UnitedHealthcare that ensures fair reimbursement so that we can protect access to essential health services for patients.”
Jefferson Health is encouraging UnitedHealthcare members to contact UnitedHealthcare to understand their coverage options “and advocate for continued access to Jefferson Health and LVHN providers,” the health system’s statement said.
