No more "all-products": Some lessons in Aetna's offer

Aetna's decision to drop its much-disliked "all-products" clause carries a powerful message about the power of physician unity and the current state of managed care.

Editorial. Jan. 29, 2001.

Aetna Inc. says that physicians no longer have to put up with its much-disliked "all-or-nothing" clause. At least that will be the case once physician contracts renew, and if those doctors make a point to ask at least 90 days in advance of the renewal -- in writing -- that the provision be dropped.

More on the details later; first let's give credit where it's due. No so long ago, "all-or-nothing" -- the contract clause, also known as "all-products," that required physicians taking Aetna's desirable PPO lines to also sign on for its lower-paying HMO products -- was dogma at Aetna. It was an especially grating edict to physicians, one that made them complicit in maneuvering their patients into more heavily managed care. Then, last year came a turnover in Aetna's top management and with it a pledge to improve relations with physicians, with an end to the "all-or-nothing" requirement as one of the welcome improvements.

Now back to those details: Although Aetna reaps much of its public relations boost all at once, it appears that most physicians will have to wait a while longer to benefit.

New Aetna contracts won't carry the provision. But Aetna has contracts covering nearly 300,000 physicians already in place. Those contracts renew on the anniversary date, whenever it falls during the year, and the "all-or-nothing" change can't be made effective until then. So many doctors presumably will be waiting months for that date to come around. [...]

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