Lehigh Valley Health Network (LVHN) will fall out of network for UnitedHealthcare’s Medicare Advantage (MA) on Jan. 26, the organizations warned patients and members Wednesday.
The system and the payer have been discussing a new contract for two years, though LVHN shared initial plans to let the contract lapse in late October.
LVHN, in statements, said the decision stems from UnitedHealthcare’s decision to cut reimbursement rates by almost 40% in 2021—“an unsustainable reduction that we never agreed to, and have legally challenged,” said Ed Pribitkin, M.D., chief physician executive at LVHN’s parent organization Jefferson Health, in a Jan. 21 video message to patients.
Also at risk is LVHN and UnitedHealthcare’s contract for employer-sponsored commercial plans and the Veteran Affairs Community Care Network (VACCN), set to expire April 25 for “most” LVHN facilities and providers.
UnitedHealthcare, in an FAQ for members, said it is still “actively negotiating” with LVHN on the employer and VACCN plans “to reach an agreement that is affordable for Pennsylvania families and employers while maintaining uninterrupted network access to LVHN.”
“However, LVHN has made the decision to end our contract for Medicare Advantage plans,” the insurer wrote.
The change affects more than 20,000 LVHN patients under a UnitedHealthcare MA plan, the system told The Philadelphia Inquirer. Not affected is UnitedHealthcare’s coverage at Jefferson Health, which acquired LVHN in a 2024 merger deal.
Messages from the two sides stressed that LVHN patients who are in the midst of treatment for a serious condition may be able to continue doing so under continuity of care rules, which extend the in-network coverage for up to 90 days. Emergency care, in line with federal law, is also unaffected.
LVHN said affected patients may remain with their providers at out-of-network rates or pay out of pocket. It also said Jefferson Health clinicians “remain in-network and may be a good option” for those affected.
“We are disappointed that United has put LVHN and our patients in this difficult position,” the system said in its Jan. 21 notice. “Our goal remains to establish a fair relationship with United that will enable LVHN to continue providing the highest-quality care.”
UnitedHealthcare, in its messages, described LVHN hospitals as “among the most expensive in eastern Pennsylvania” and said the system was demanding a one-year price hike of more than 20%. Much of that rate increase would have to be paid by Pennsylvania employers.
“These companies are also faced with difficult decisions about benefits and costs, often leaving them with no other choice than to pass a portion of these cost increases to their employees, resulting in higher deductibles, out-of-pocket expenses and employee contributions,” the insurer said.
As for alternatives, UnitedHealthcare pointed plan members to other local providers in its network and highlighted a recent multiyear agreement it reached with St. Luke’s University Health Network.
Financial pressures squeezing providers and insurers alike have laid the groundwork for high-profile contract negotiation breakdowns in recent years, such as those between UnitedHealthcare and Johns Hopkins or Mayo Clinic. There have also been instances where the sides have been able to mend their relationships, as was the case when Providence returned to Aetna’s network for most of 2025 or Jefferson Health’s much shorter break with Cigna last March.