UnitedHealthcare–Ascension Wisconsin Agreement

11/05/2025

UnitedHealthcare and Ascension Wisconsin: From Contract Breakdown to Multi-Year Agreement 

 

UnitedHealthcare and Ascension Wisconsin reached a multi-year agreement in mid-October 2025, ending a 13-day period during which thousands of patients faced out-of-network status at one of Wisconsin's largest healthcare systems. The agreement, effective immediately and retroactive to October 1, 2025, restored in-network access for patients enrolled in commercial, Medicare Advantage, and Medicaid plans. 


The Contract Dispute 

The conflict between UnitedHealthcare and Ascension Wisconsin developed over several months of contract negotiations that failed to produce an agreement before the existing contract expired on October 1, 2025. The dispute centered on reimbursement rates, with both organizations presenting conflicting positions on fair compensation. 

Ascension Wisconsin, which operates 16 hospitals (12 owned and 4 jointly operated), employs more than 1,000 providers, and maintains 165 locations throughout the state, argued that UnitedHealthcare's proposed rates did not adequately reflect the financial pressures facing healthcare providers. Sean Fitzpatrick, Vice President of External Communications at Ascension, stated that the reimbursement rates proposed by UnitedHealthcare did not account for significant financial pressures, including inflation and rising costs for medication, equipment, and supplies. 

"The reimbursement rates UnitedHealthcare proposed do not adequately account for the significant financial pressures facing healthcare providers," Fitzpatrick said. "We remain open to resuming discussions with UnitedHealthcare, should they be willing to engage in a way that supports that goal." 

UnitedHealthcare presented a different perspective on the negotiations. According to the insurer, Ascension Wisconsin's demands would have significantly increased healthcare costs for consumers and employers in Wisconsin. The company maintained that its proposals offered market-competitive rates consistent with what other health systems in the region receive. 

Dustin Hinton, CEO of UnitedHealthcare Wisconsin, stated: "Ascension Wisconsin declined our latest proposal, which offered market-competitive rates, and chose to leave our network. We also proposed extending the contracts to allow members continued network access to Ascension while we continue discussions. Ascension refused. Our primary focus at this time is providing our members uninterrupted access to care, either through continuity of care or by supporting them as they transition to new providers." 


Impact on Patients 

When the contract expired on October 1, 2025, patients covered by UnitedHealthcare lost in-network access to Ascension Wisconsin hospitals, outpatient facilities, physician practices, and Ascension Medical Group locations. The out-of-network designation affected patients with employer-sponsored and individual commercial plans, Medicare Advantage plans (including Group Retiree and Dual Special Needs Plans), and UnitedHealthcare Community Plans (Medicaid). 

Affected facilities included major hospitals throughout Wisconsin: 

  • Ascension St. Francis Hospital 
  • Ascension Columbia St. Mary's Hospital in Milwaukee 
  • Ascension Columbia St. Mary's Hospital in Ozaukee 
  • Ascension NE Wisconsin - St. Elizabeth Hospital in Appleton 
  • Ascension NE Wisconsin - Mercy Hospital in Oshkosh 
  • Ascension Calumet Hospital in Chilton 

The disruption left patients facing difficult decisions: switch to new healthcare providers, change insurance plans during open enrollment, or pay significantly higher out-of-network costs to continue care at Ascension facilities. UnitedHealthcare implemented continuity of care provisions for patients in active treatment for serious or complex conditions, including newly diagnosed or relapsed cancer patients and those undergoing active cancer treatment. 

Local media reported instances of patients postponing care, searching for new doctors, and preparing to pay high out-of-network fees to maintain continuity with established providers. 


Resolution and Agreement Terms 

On October 14, 2025—13 days after the contract expiration—UnitedHealthcare and Ascension Wisconsin announced they had reached a multi-year agreement restoring in-network access. The agreement became effective immediately and applied retroactively to October 1, 2025. 

UnitedHealthcare stated in its announcement: "Our top priority throughout this negotiation was to provide the families we serve access to quality, affordable health care from the doctors and care providers they know and trust, and this agreement accomplishes that goal." 

Daniel Jackson, CEO of Ascension Wisconsin, described the agreement as "more than just a contract" in a statement: "It is a reaffirmation of our Mission to serve all with dignity and compassion. By securing fair and sustainable reimbursement, we are able to continue supporting our caregivers, strengthening our ministries, and providing high-quality, compassionate care across the communities we serve." 

According to Ascension Wisconsin, any services patients received between October 1 and October 13 were held and will be processed at in-network rates. Patients should not receive bills for out-of-network costs during that period. UnitedHealthcare confirmed it was mailing letters to members who were previously notified of the network disruption, informing them that Ascension Wisconsin facilities, hospitals, and physicians are back in-network. 


Industry Context 

Dan Sacks, an associate professor of risk and insurance at the University of Wisconsin-Madison's School of Business, noted that contract disputes between healthcare providers and insurers are a normal part of the negotiation process. However, he indicated it was rare for talks to break down to the extent they did in this case. 

"What's at stake in these contract disputes is essentially how much hospitals and doctors are going to get paid by insurers when you or I get care there," Sacks explained. He added that while prolonged negotiations are common, leaving patients in limbo for an extended period is unusual. 

Sacks also noted potential benefits and drawbacks of such disputes: "There is an upside to having an insurer negotiating hard, which is that it might keep premiums lower than they otherwise would be. It's costly for Ascension if patients end up canceling scheduled visits. It's very costly for patients if their care is disrupted." 

The Wisconsin dispute was not an isolated incident. Earlier in 2025, Ascension Florida reached a short-term agreement with UnitedHealthcare to remain in-network during negotiations before ultimately securing a multi-year contract. These parallel negotiations suggest broader challenges in aligning reimbursement expectations between large health systems and major insurers. 

The timing of the Wisconsin resolution coincided with Medicare open enrollment and the approaching start of Affordable Care Act enrollment on November 1, potentially providing additional motivation for both parties to reach an agreement before patients made coverage decisions for 2026. 


Implications for Healthcare Operations 

The two-week disruption highlighted the operational and financial risks both healthcare systems and insurers face when contract negotiations fail. For Ascension Wisconsin, the out-of-network status potentially resulted in canceled or postponed appointments, patients seeking care elsewhere, and administrative complexity in managing patient transitions. 

For UnitedHealthcare, the network gap risked member dissatisfaction and potential loss of business to competitors offering broader provider networks. The company's emphasis on continuity of care provisions and member support during the disruption reflected efforts to mitigate these risks. 

The dispute also underscored the leverage dynamics in healthcare contracting. Ascension Wisconsin represents a significant portion of Wisconsin's healthcare infrastructure with 16 hospitals, particularly in southeastern Wisconsin and the Fox Valley region. UnitedHealthcare is one of Wisconsin's largest insurers by market share. The eventual resolution suggests neither party could sustain the out-of-network status long-term without a significant business impact. 

Healthcare operations leaders monitoring such disputes should note several factors: the increasing frequency of public contract negotiations between major systems and insurers, the willingness of both parties to allow temporary network disruptions, and the ultimate prioritization of member/patient access in reaching a resolution. The retroactive effective date of the Ascension-UnitedHealthcare agreement provided financial protection for patients who received care during the disruption period, suggesting both organizations recognized the need to minimize patient financial harm resulting from the negotiation breakdown. 

Specific financial terms of the multi-year agreement were not disclosed publicly, consistent with standard industry practice for such contracts. 


Sources: 

  1. Wisconsin Public Radio. (October 14, 2025). "Ascension Wisconsin, UnitedHealthcare reach deal to restore in-network access." 
  2. FOX6 Milwaukee. (October 14, 2025). "UnitedHealthcare, Ascension Wisconsin agreement reached; here's what we know." 
  3. UnitedHealthcare. "Network Negotiations with Ascension Wisconsin." https://www.uhc.com/ascensionwi 
  4. WTMJ Milwaukee. (September 30, 2025). "Ascension Wisconsin-UnitedHealthcare contract set to expire; what it means for patients." 
  5. Wisconsin Public Radio. (September 2, 2025). "Ascension Wisconsin could be dropped by UnitedHealthcare if a new contract isn't reached by October." 
  6. TMJ4 Milwaukee. (October 1, 2025). "Ascension Wisconsin and UnitedHealthcare contract expires; community explores next steps." 
  7. Racine County Eye. (October 13, 2025). "Ascension Wisconsin and UnitedHealthcare reach new agreement, claims between Oct. 1-13 will be covered." 


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