In just under a month, two healthcare providers could strike a deal. If not, many state employees might find themselves facing higher health insurance costs.
On Tuesday, the state treasurer indicated that preparations were underway for the potential fallout if Duke and Aetna fail to come to terms.
Time is running out, and those involved are urging leaders to step in with solutions.
According to state treasurer Brad Briner, pressure is mounting on patients to secure a new provider, as Aetna may sever ties with Duke Health in about four weeks. It’s a tense situation.
Interestingly, only around 3% of the 700,000 state employees currently use Duke Health.
Briner mentioned that in a scenario where Aetna drops Duke, no one may retain coverage.
“We’re getting them ready for the possibility of leaving the network,” Briner noted.
The state is making plans, claiming that Duke is prepared to take on the increasing costs of healthcare.
Dr. Thomas Owens, executive vice president of Duke Health, spoke with WRAL News last week regarding the ongoing discussions with Aetna.
“I want to clarify that this negotiation is between Duke Health, which is a nonprofit, and Aetna, a for-profit entity,” Owens said. “We’re not negotiating with the treasurer.”
He added, “Over the past four years, despite significant economic challenges in the healthcare sector, Aetna hasn’t raised rates during this time.”
Even with these hurdles, Duke Health managed to generate $600 million in revenue last year.
With financial resources at their disposal, Duke boasts over $4 billion in total investments.
Briner commented, “Duke’s existing fees are not the problem, but we can’t risk playing games with our members. This isn’t the partnership we need.”
“We receive a 5% draw annually to cover operating costs, but the ongoing operations of our healthcare system require constant investment, as the reimbursements don’t match the rising costs of care.”
Duke Health and Aetna face a looming deadline of October 20th. If an agreement isn’t reached, Aetna customers will lose coverage at Duke facilities.
Briner stated that the state’s health plans are designed to manage significant risks over specific periods.
“When Duke escalates situations by claiming we are jeopardizing our members’ lives, it’s simply untrue,” Briner asserted. “In fact, state law has provisions to protect individuals in critical conditions by ensuring they can continue to receive care.”
