P&T
Our
Other
Journal
MediMedia Managed Markets
Managed Care

 

Denver Docs Bolt Aetna Before It Ends 'All-Products'

MANAGED CARE February 2001. © MediMedia USA
News and Commentary

Denver Docs Bolt Aetna Before It Ends 'All-Products'

MANAGED CARE February 2001. ©MediMedia USA

Some 8,000 Denver-area residents were left to find new doctors when 240 physicians affiliated with MedWest Medical Group dropped Aetna U.S. Healthcare in a dispute over contract terms. The doctors did not renew their Aetna contract when it expired Jan. 31.

The physicians were angry about payment rates and what they called Aetna's "onerous" administrative requirements — including its insistence, at the time, that the group accept Aetna's unpopular all-products contract clause, which forces physicians who contract for one Aetna product to accept members of all Aetna products.

Two weeks after the group said it would leave Aetna — though not to suggest a cause and effect — the insurer said it would end its all-products requirement unilaterally. Aetna, which has been trying to improve physician relations, also agreed to stop forcing its physicians to take pharmacy risk, and to accept actuarially sound capitation rates. The changes were negotiated with the California Medical Association.