Aetna and Providence Reach Agreement for Health Coverage in Oregon
Oregonians with Aetna health insurance can now access care at Providence hospitals and clinics without facing high out-of-network charges.
Providence Health & Services in Oregon and Aetna, which is owned by CVS Health, recently declared they have established a new multi-year agreement. This agreement reinstates Providence, the largest health system in the state, back into Aetna’s network. It encompasses eight hospitals and over 90 clinics across Oregon.
The changes took effect on December 1 for Aetna commercial insurance members in the Portland area and throughout the state. Earlier, Providence Medford Medical Center and Southern Oregon Health System clinics had rejoined the network on November 15.
This new deal puts an end to a tough separation that occurred after contract negotiations between Providence and Aetna fell apart around a year ago, primarily over payment rates. Such disputes seem to be becoming more frequent, leaving patients often stuck in the middle as hospitals and insurers tussle over the fast-growing costs of healthcare.
Kathy Hughes, who is the vice president of Aetna’s Western Regional Network, commented that the collaboration broadens options for members. She noted that Providence will once again provide “high-quality, convenient care” to Aetna customers across the state.
However, it’s worth noting that access isn’t uniformly spread across Oregon. While Providence hospitals, clinics, and doctors are completely in-network with Aetna’s commercial plans statewide, Aetna’s Medicare Advantage plan members have in-network access to Providence only in Southern Oregon, including the Medford region.
This limitation affects a lesser number of Aetna members in Oregon. Current data from the Centers for Medicare and Medicaid shows that just over 14,000 individuals in Oregon are enrolled in Aetna’s Medicare Advantage plans.
By contrast, a significantly larger number of residents have Aetna commercial insurance. According to the latest data, more than 250,000 Oregonians are covered through self-funded employer plans managed by Aetna, with an additional 50,000 enrolled in various individual, group, or student commercial plans.
