Aetna's new fee schedule bad news for Fla. doctors

Physicians say the insurer's move would cut their pay by up to 50%.

By Cheryl Jackson, amednews staff. Aug. 20, 2001.

Florida doctors say the nation's largest health insurer is cutting their pay to offset some financial woes.

Aetna Inc. has notified Tampa-area physicians that, starting in November, the company will pay 80% of Medicare, according to a letter signed by Mary McCluskey, MD, a network medical director in Tampa. The letter was provided to AMNews by the Tallahassee-based Federation of Physicians and Dentists, a labor union.

The company's action translates to a 30% to 50% pay cut for the physicians, said Jack Seddon, the federation's executive director.

Aetna officials would not confirm any figures, but said it "would standardize our payment structure and begin paying fee-for-service to all primary care physicians" in Tampa and south Florida.

The company has been paying Florida primary care physicians with fewer than 100 Aetna HMO patients on a fee-for-service basis since last spring.

"We have been reviewing our reimbursements to physicians as part of our national initiative to improve relationships," said Marlene Baltar, the insurer's spokeswoman in Florida. "We've been talking with physicians, and talking about where the satisfaction and dissatisfaction lies."

The Florida fee schedule letter, dated July 2001, began arriving in physician mailboxes the last week of the month.

Physicians have 30 days to reject the terms.

Physicians say the move is a tactic to get Aetna on solid financial footing.

During the first quarter of 2001, Aetna Inc. reported a loss of $36.6 million -- or 26 cents per share -- attributing much of that to higher-than-expected medical costs.

"Aetna's had some tough times financially. They're saying they're trying to turn the company around," Seddon said. "They're trying to do that by dipping into the pockets of doctors who are having their own financial problems."

"There are only five players in Florida, so every player is significant," said Michael Wasylik, MD, chair of the Hillsborough County (Fla.) Medical Assn.'s managed care committee.

The Tampa orthopedic surgeon said most physicians who received the letter said they would not agree to a pay cut.

"Physicians get to the point in time that they finally realize that it's just not financially viable," he said.