Ongoing Negotiations Between UConn Health and Aetna
A week after UConn Health’s contract with Aetna, a significant health insurance provider, ended, both parties are holding firm in their negotiations. This standoff could mean that around 15,000 patients might face much higher copays for medical services.
UConn Health, based in Hartford, and Aetna, which is part of CVS Health, are trying to negotiate an extension of their contract but accuse each other of not making reasonable offers.
If a new agreement isn’t reached, most patients who have Aetna insurance and seek care at UConn Health facilities will lose their “in-network” status.
The core issue in the negotiations revolves around the reimbursement rates Aetna is willing to pay for services provided by UConn Health, which includes John Dempsey Hospital and a network of clinics and over 700 providers.
Aetna released a statement indicating that UConn Health is demanding much higher reimbursement rates, which, according to Aetna, would raise healthcare costs for families, employees, and retirees across Connecticut. They emphasized their commitment to negotiating a fair deal that keeps healthcare affordable for their members.
In contrast, UConn Health stated on their website that Aetna hasn’t provided a proposal that supports the quality of care costs adequately and expressed disappointment over the lack of agreement.
UConn Health further claimed that while Aetna’s profits are on the rise, it pays the lowest commercial rates in Connecticut for the only public academic health system. They believe this creates an unsustainable burden that Connecticut’s taxpayers have to bear.
UConn Health affirmed its dedication to its patients and pledged to continue negotiating with Aetna in good faith to return their hospitals and providers to Aetna’s network as soon as possible.
Regarding out-of-network care, patients might confuse costs, as sometimes services are not covered except in emergencies, and, when they are, out-of-pocket costs can be significantly higher. Additionally, patients using out-of-network services may be billed for the remainder after the insurance payment.
This situation may require patients to switch to new in-network providers. However, Connecticut retirees and those in the Aetna Medicare PPO Expanded Service Area can still choose out-of-network providers.
Patients currently receiving treatment or those who have scheduled procedures may be able to continue at in-network rates for up to 90 days. UConn Health clarified that emergency care would still be available at in-network rates.
This tough negotiation stance is not new for UConn Health. Earlier in the year, they pressured another health insurance company, ConnectiCare, for better reimbursement rates by taking down billboards along major highways after their contract expired. They successfully reached a new agreement with ConnectiCare.
