NewYork-Presbyterian & Healthfirst Contract Termination

Breaking: NewYork-Presbyterian Unexpectedly Terminates Multi-Year Contract with Healthfirst 

Nana Kazhiloti, Credentialing Specialist, WCH  

Major Network Disruption Affects Provider Community 

In a development that has significant implications for healthcare providers across New York, NewYork-Presbyterian Hospital System has abruptly terminated its contract with Healthfirst, creating referral challenges and care coordination issues for the broader provider network. This unexpected decision, with no officially disclosed reasons, will impact how thousands of providers manage their Healthfirst patients' care pathways. 

The Timeline: From Partnership to Sudden Termination 

Fall 2024: A Promising Partnership  

In fall 2024, Healthfirst and NewYork-Presbyterian agreed to a multi-year contract that is in effect through 2027 and provides Healthfirst members in-network access to the NewYork-Presbyterian system and affiliated providers. This agreement was viewed as beneficial for the entire provider ecosystem, ensuring seamless referral patterns and care coordination. 

July 7, 2025: The Unexpected Announcement  

However, on July 7, 2025, NewYork-Presbyterian notified us of their decision to terminate our contract, without cause, effective November 3, 2025. The health system prematurely ended a contract with Healthfirst that was supposed to stay in place through 2027, the insurer said. 

Important Note: The specific reasons for this termination have not been officially disclosed by either party. Both organizations have declined to provide detailed explanations for the contract dissolution, leaving the healthcare community to speculate about potential underlying factors. 

Impact on Provider Networks 

Affected Healthcare Systems and Providers: As a result, NewYork-Presbyterian and its affiliated physicians, including ColumbiaDoctors and Weill Cornell Medicine, are scheduled to be out-of-network effective November 3, 2025. According to NewYork-Presbyterian's official statement, starting November 3, all NewYork-Presbyterian Hospitals, NewYork-Presbyterian Medical Group practices, NewYork-Presbyterian affiliated organizations, and care teams from ColumbiaDoctors and Weill Cornell Medicine will be considered out-of-network providers for Healthfirst members. 

This affects: 

• Primary Care Providers: Need to establish new referral relationships for specialty care 
• Specialists: May lose referral sources and need to coordinate care transitions 
• Emergency Services: Providers must inform patients about potential coverage gaps 
• Affiliated Networks: ColumbiaDoctors and Weill Cornell Medicine practitioners will be out-of-network 

Clinical Implications for Providers 

Immediate Concerns: 

• Referral Pathway Disruption: Established referral relationships will be severed 
• Care Continuity Challenges: Ongoing patient treatments may face interruption 
• Administrative Burden: Increased prior authorization requirements for out-of-network services 
• Documentation Needs: Enhanced justification required for continued care at NewYork-Presbyterian 

Specialty Care Impact: The termination particularly affects providers who regularly refer to NewYork-Presbyterian's specialized services, including: 

• Complex surgical procedures 
• Advanced cardiac care 
• Oncology services 
• Pediatric specialty care 
• Emergency and trauma services 

Provider Network Response 

Healthcare providers across the region are expressing concern about the sudden nature of this termination. Many have built long-standing relationships with NewYork-Presbyterian specialists and are now forced to rapidly identify alternative referral options for their Healthfirst patients. 

The abrupt nature of the termination has been particularly challenging, given that the original contract was intended to provide stability through 2027. 

Financial and Operational Implications 

For Referring Providers: 

• Need to identify alternative in-network specialists quickly 
• Potential impact on patient satisfaction scores 
• Increased administrative costs for care coordination 
• Possible revenue impact from disrupted referral patterns 

For the Healthcare System: 

• Redistribution of patient volume across remaining in-network providers 
• Potential capacity strain on alternative healthcare systems 
• Need for enhanced care coordination protocols 
• Impact on regional healthcare delivery patterns 

Current Negotiations and Provider Considerations 

NewYork-Presbyterian has indicated they remain committed to negotiations, stating: "We want to reassure you that our patients' health and well-being are our top priority. We are committed to negotiating with Healthfirst to reach an agreement that puts our patients first and allows them to continue to receive the high-quality care they have come to trust." 

However, providers cannot wait for a resolution and must begin preparing alternative care pathways immediately. In the event we are unable to reach an agreement by November 2, starting November 3, all affected services will become out-of-network. 

Action Items for Healthcare Providers 

Immediate Steps (Now through November 2, 2025): 

1. Audit Current Referrals: Review all pending and planned referrals to NewYork-Presbyterian affiliates 
2. Identify Alternative Providers: Establish relationships with other in-network specialists 
3. Patient Communication: Prepare communication strategies for affected patients 
4. Update Referral Protocols: Modify standard referral pathways and documentation 
5. Staff Training: Ensure staff understand new coverage limitations and alternatives 

Care Coordination Priorities: 

• Schedule urgent consultations before the November 3rd deadline 
• Facilitate medical record transfers for ongoing care 
• Establish communication with alternative specialty providers 
• Update care management protocols and pathways 

Affected Patient Populations 

Patients who are covered by a Healthfirst Medicare Advantage, Medicaid, Child Health Plus, Essential Health Plan, or Qualified Health Plan (Individual Exchange) product will need to change their healthcare provider to one who is in-network if an agreement is not reached by November 2, 2025. 

Network Adequacy Considerations 

Healthcare providers should assess whether Healthfirst's remaining network provides adequate specialty coverage for their patient population. Key considerations include: 

• Geographic accessibility of alternative providers 
• Specialty coverage gaps that may emerge 
• Quality comparisons between available alternatives 
• Patient preference and established relationships 

Provider Strategy 

Short-term Adjustments: Providers should focus on ensuring continuity of care for patients currently receiving treatment through NewYork-Presbyterian while establishing new referral relationships with other in-network providers. Healthfirst members can continue to access in-network care at all NewYork-Presbyterian hospitals and with NewYork-Presbyterian affiliated providers through November 2, 2025. 

Long-term Considerations: This contract dispute highlights the importance of maintaining diverse referral networks and not becoming overly dependent on any single healthcare system. Providers may want to reassess their referral patterns to ensure greater resilience against future network changes. 

Industry Implications 

This termination raises important questions for the provider community about: 

• Contract stability in healthcare networks 
• The impact of payer-provider disputes on care coordination 
• The need for alternative referral pathways 
• Protection mechanisms for ongoing patient care 

Speculation on Underlying Causes: While the official reason for termination remains undisclosed, industry observers have suggested various potential factors that commonly lead to such contract disputes, including: 

• Reimbursement rate disagreements 
• Administrative burden concerns 
• Quality metrics disputes 
• Network adequacy requirements 

It's important to note that these are industry speculations, not confirmed causes. Neither NewYork-Presbyterian nor Healthfirst has provided specific reasons for the contract termination. 

As negotiations continue between Healthfirst and NewYork-Presbyterian, healthcare providers must proactively manage this transition to minimize the impact on patient care. The November 3rd deadline is rapidly approaching, and the provider community's ability to adapt quickly will be crucial for maintaining care quality and patient satisfaction. 

Providers are encouraged to stay informed about the negotiation status while simultaneously preparing robust alternative care pathways. The healthcare community's resilience will be tested, but proactive planning and strong inter-provider collaboration can help minimize disruption to patient care. 

Sources 

1. Healthfirst Official Statement: "Important Update Regarding NewYork-Presbyterian" - healthfirst.org/whattoknow 
2. NewYork-Presbyterian Official Update: "NewYork-Presbyterian and Healthfirst Update" - nyp.org/healthfirst 
3. Crain's New York Business: "New York-Presbyterian suddenly terminates contract with Healthfirst" - crainsnewyork.com 

Last updated: Based on information available as of August 2025. Providers should monitor official communications from both organizations for the most current information. 

 

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