Health
6:35 am
Mon January 17, 2011

UNC Hospitals & Aetna in Rate Dispute

People around the Triangle with Aetna health insurance are hearing that UNC Hospitals may no longer be an in-network insurer for them.

The letters went out last week from both Aetna and UNC Hospitals, saying that come February fifth, UNC will no longer accept Aetna insurance.

"Oh my gosh, I have cystic fibrosis and it requires a lot of doctor visits"


32-year-old Laura Smith has been seeing doctors at UNC since 1998. If the hospital becomes out-of-network for her, her co-pays go way up.

"My first thought was... how am I going to see my doctor? I have this incredible relationship with him, it's like we're partners in my health care."


Every few years, hospitals and insurers re-negotiate terms. At times, the talks can turn into a game of chicken, with one side waiting for the other to budge... and patients caught in the middle. UNC spokeswoman Jennifer James:

"What we have asked for, the rates in the terms, they are reasonable in the marketplace, affordable, and they enable us to continue to provide high quality health care. And unfortunately, we've made a lot of concessions with Aetna in the past few months and they have been unwilling to accept any of our proposals."


Aetna covers about 350,000 people in the state. About ten thousand could pay more for doctor visits if UNC and Rex Hospitals can't agree with Aetna. Company spokesman Walt Cherniak:

"Aetna has a couple of obligations to our customers. One primary one is to provide them access to quality hospitals and physicians, another is to help keep a handle on those rising health care costs... that's part of what our customers pay us to do... So we are doing this on behalf of our customers."


Cherniak says the two parties are in communication, but no formal negotiation sessions are scheduled.