Christ Hospital is the latest Hudson County medical facility to drop Aetna U.S. Healthcare. In a letter that began arriving in mailboxes last week, Aetna notified its customers that Christ Hospital no longer participates with the health care provider.
“We want to let you know that Christ Hospital will leave our network on June 28, 2012,” the letter begins. “This means that as of June 29, 2012, this facility will no longer be part of the Aetna network. You can receive services at Christ Hospital on an in-network basis through June 28, 2012.
“Beginning June 29, 2012, only members in plans that offer out-of-network coverage will continue to have access to this facility. Of course, in the event of an emergency, Christ Hospital will continue to be available to all members, regardless of plan type.”
AFFORDABLE – Many companies that offer health coverage subscribe to Aetna because the insurer offers cheaper rates compared to other insurers.
Earlier this year Jersey City Medical Center severed ties with Aetna – a divorce that is scheduled to go into effect beginning June 15, unless the parties can reach a new agreement on reimbursement rates. More recently, the University of Medicine and Dentistry of New Jersey, which has campuses in Newark and elsewhere, also cut ties with Aetna.
Hoboken University Medical Center, Bayonne Medical Center, and the Secaucus-based Meadowlands Hospital Medical Center are also no longer in-network facilities for Aetna.
Now that Christ Hospital has announced plans to drop Aetna, Palisades Medical Center in North Bergen is the only Hudson County-based facility where all Aetna customers can go, regardless of their coverage plan.
Affordable, but not acceptable
Many employers that offer health coverage to their workers subscribe to Aetna because the company offers the cheapest rates when compared to most other insurers. Aetna is often the health insurer of choice for companies in the private sector where employers and workers typically split the cost of monthly premiums.
“We have a dual responsibility to our customers,” Aetna spokeswoman Susan G. Millerick told the Reporter in April. “The first is to provide them with access to comprehensive health benefits coverage that is both accessible and affordable. The second is to help contain rising health care costs which threaten their ability to continue providing coverage for their workers – particularly hospital costs, which are rising at rates that far exceed physician and other professional services. We take these responsibilities very seriously. On average, our customers’ revenues are not increasing at the rate some of our providers have previously demanded. We simply cannot agree to increases that substantially exceed the consumer price index.”
Millerick said the company has about 27,000 members in Hudson County
Hospital administrators argue, however, that Aetna also pays the lowers reimbursement rates – rates that do not cover the cost of care. And New Jersey hospitals aren’t the only ones that have ended their relationships with Aetna. In April, Simi Valley Hospital in California severed ties with the health insurer because of reimbursement rates. An estimated 10,000 patients in the Philadelphia-area were affected when Abington Medical Specialists dropped Aetna in October of last year. According to news accounts, doctors from Abington Medical Specialists provided 80 percent of the cardiology care at Abington Memorial Hospital.
Despite the trend, hospitals say they are trying to reestablish ties with Aetna.
“It’s our goal to be in-network with all insurers,” said Jersey City Medical Center spokesperson Mark Rabson. “We look forward to Aetna returning to the table, negotiating with us, and making an offer that’s fair and equitable to both parties.”
He added that Aetna customers can still use the medical center in cases of emergency, regardless of the type of coverage plan they have.
E-mail E. Assata Wright at email@example.com.