Allshores’ longstanding relationship with the American Northwell Health hospital group is under review.

Patients from Bermuda are sometimes sent to Northwell hospitals in New York and Connecticut, while Northwell specialists in cardiology, pulmonology and sleep disorders make regular visits to the island.

Northwell maintains 22 hospitals in Connecticut and New York, with Lenox Hill Hospital in Manhattan being one of the most well known.

In 2020 it featured in a Netflix documentary called Lenox Hill.

Joe Leggio, Northwell’s vice-president executive director, international services explained that the conversation is centred around off-island care.

A spokeswoman for Allshores said negotiations are specifically about cardiac care.

“Northwell continues to be on the Allshores open network,” Allshores said. “This hasn't changed.”

However, talks with Northwell began several months ago about Northwell’s place in Allshores’ speciality cardiology network.

“Negotiating with network providers is standard practice and is how we ensure providers deliver value,” Allshores said. “This helps avoid significant premium increases for Allshores members.”

She said while negotiations are ongoing, new cardiology referrals to Northwell are being reviewed on a case-by-case basis.

“We have amazing hospitals in our cardiology network, including Johns Hopkins and Cleveland Clinic,” she said.

Cleveland Clinic has been rated as the top cardiology hospital in the United States, but slipped to third in the 2025-2026 US News & World Report on hospitals, replaced by New York’s NYU Langone.

Johns Hopkins was rated 10th, while Northwell’s Lenox Hill Hospital cardiology department was ranked 16th in the United States.

“Referrals to Northwell may still be approved, however, even through this negotiation phase,” Allshores said.

Northwell’s Mr Leggio said while the negotiations centred on sending Bermuda patients overseas, both overseas and local care were equally important, and were linked.

The Bermudian insurer said it remained committed to giving members options that ensure the best quality care and value.

“The cost of going to a hospital where fees are extremely high ends up being paid for through higher premiums for all members of that health plan,” Allshores said.

“This is why we have networks in place, as they often come with pre-negotiated rates to ensure our members get access to the quality care they need at an acceptable cost to their plan.”

She said hospitals in New York can be two or three times as expensive as other hospitals, even though the best rated hospitals are often elsewhere.

“We have an important role not just in ensuring the best place for the best outcome for an individual patient, but in trying to control premiums for all the other people who are in the same health plan as the individual seeking care overseas,” Allshores said.

“Affordability of premiums, while preserving quality, is a pressing concern for all Bermudians. We hear this from members and clients and it is our responsibility to have the tough conversations or to advocate for our members and plans when we see a challenge.”

She said that if patients were being treated at one hospital regularly they would not be yanked out of that relationship and forced to attend another, because continuity of care is important to Allshores.

Joe Leggio, vice-president executive director, international services at Northwell said the group remained hopeful that they could continue to provide on-island and off-island care to Bermuda.

“We value our partnership with Allshores and share the same goal: keeping patients at the centre and ensuring Bermudians have access to the highest-quality care,” Mr Leggio said.

“We are continuing productive conversations to maintain strong care options for the community that support providing continuity of care for all patients.”

He said this marks Northwell’s 10th year in practice.

Allshores said changes like this do not happen frequently.

“From time to time we will negotiate contracts with hospitals in our networks, or who wish to enter our networks,” a spokeswoman for the insurer said.

“There are not frequent changes, as we work to maintain a stable network for our members. Continuity of care would always be upheld to ensure there are no disruptions.”