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Tens of thousands of New Yorkers who head to doctors offices and hospitals run by Continuum Health Partners may have to start looking elsewhere, or pay more out of pocket, if a contract dispute is not settled.

The hospital group that includes St. Luke's Roosevelt Hospital and Beth Israel Medical Centers, along with Long Island College Hospital and New York Eye and Ear Infirmary, has not been able to agree on a new contract with insurance giant, United Healthcare. Oxford and United customers could be affected by an extended March 1st deadline.

The main sticking point is a demand that could reduce reimbursements made to health care providers.

“An example of this is a requirement that a hospital notify United within 24 hours of a patient's admission to the hospital, and if we don't provide them with that notice, they could reduce payment by 50 percent,” said Contiuum Health Partners Senior Vice President Ruth Levin.

“Basically they are saying, ‘just get another doctor. It doesn't really matter,’” said Dr. Jane Falkenstein of Beth Israel Medical Center.

It's a matter that's become so heated that Continuum's filed complaints with the state attorney and initiated court action, in particular because of wording in termination letters to doctors with sole admitting privileges at their hospitals. A statement from United says they plan to “continue to negotiate in good faith,” but it goes on to say "…Continuum's actions keep us from the negotiation table and distracts from the real focus which should be on establishing a contract that puts in place affordable access to health care for our members."

Insurance industry experts say while intense, these kinds of contract disputes typically get resolved. But one thing that could be making things different is a system that finally seems to be on the cusp of health reform.

“It is something we have to be cognizant of because as government ratchets down their payment to providers, those providers are going to be looking to the private insurers to make up those lost payments,” said American Corporate Benefits President Richard Allen. “And if private insurers do not make up those lost payments, what is going to happen is patient care is going to suffer.”

If Continuum and United cannot come to an agreement, patients already in continuous treatment for a disease, along with pregnant women who have to deliver past the March 1st deadline, will still be covered without any additional cost. Emergency room visits are always covered.

In the meantime, both parties have been advising all patients to brace for the real possibility of a change in their regular healthcare.