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Large Washington state medical center to drop Aetna

A hospital system in Seattle is cutting ties with the nation's largest health insurer, pulling 2,000 physicians out of the Aetna network.

By Myrle Croasdale, amednews staff. Jan. 21, 2002.

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As part of its plan to regain profitability, Aetna says it's willing to drop out of markets that aren't making it any money. However, Seattle -- where a large health system has cut ties with Aetna -- wasn't supposed to be part of that plan.

In Seattle, Swedish Medical Center and its 2,000 associated physicians are scheduled to drop all Aetna contracts as of Feb. 20, resulting in the loss of 20% of Aetna's physician network in that area. As of Dec. 31, 2001, 15,000 Aetna members no longer had access to one of Swedish's three facilities. By Feb. 20, this number will rise to 60,000 as contracts throughout the Swedish network expire.

Ron Sperling, chief financial officer of Swedish Medical Center, said Aetna just wasn't paying enough.

"It's about money," he said. "We're asking Aetna to pay a similar amount as other insurers in the community. They're at a lot lower rate. If we had our druthers, we'd like an arrangement with them, because they are a prominent insurer."

Physicians affiliated with the Swedish campus in Seattle may feel a pinch. Aetna members make up only 5% of Swedish's annual revenue of $750 million. Aetna has 400,000 members in the state of Washington.

For the most part, the 2,000 associated physicians understand their position, hospital officials said.

Ken Brown, executive director for Providence Medical Group, the 65 physicians employed by the hospital, said they were working with Aetna to make sure patients with ongoing care weren't left in the lurch.

"Generally, the physicians understand where the hospital is at," Brown said. "The impact on physicians' patient relationships is a concern. Anyone with Aetna who is in a course of treatment will be reviewed on a case-by-case basis to see that their care isn't interrupted. Aetna has been cooperative on that front. Clearly there are folks who will have to change doctors or change health insurance." [...]