Aetna and Dignity are locked in a contract dispute: Will you lose your health coverage?
Thousands of Aetna members in Sacramento and beyond will no longer be able to access their Dignity Health doctors at discounted in-network rates starting April 1 if the two companies don’t reach a new business arrangement.
“Over the last several months, we have been working with Aetna to reach a new, responsible contract agreement that puts patients first and keeps Dignity Health doctors and hospitals in-network for Aetna members,” leaders of Dignity Health said in a statement sent to The Sacramento Bee Friday. “We know Aetna shares our goal of protecting patients’ access to care.”
Dignity officials, in a note on the company website, urged patients to keep any appointments and procedures they already have authorized and scheduled. Do not delay routine health screenings, procedures, or tests that are vital to your health, they advised.
Aetna executives described the negotiation as a normal part of the company’s business operations in a statement sent to The Bee on Friday.
“We are focused on avoiding unsupportable increases in reimbursement rates that would raise costs for our members and plan sponsors in the Sacramento community,” Aetna executives said in the statement. “We have a responsibility to our members and health plan sponsors to negotiate fair reimbursement rates. We remain committed to negotiating in good faith for a fair contract.”
Insurers negotiate rate reductions by excluding high-cost or low-quality providers from a network, and they can offer reduced rates to customers who agree to use providers in those groups. When customers opt for a provider out of the network, they pay a significantly higher cost.
Dignity’s note to patients explained that some Aetna members may be able to keep seeing their current care team after April 1 because of California’s continuity-of-care law. To find out if you qualify, submit a transition coverage request.
Neither Dignity nor Aetna responded to questions about the exact number of patients covered by the agreement. The contract expiration won’t affect all of Dignity’s patients in California, Arizona and Nevada right away — and some not at all:
▪ HMO patients with providers in the Mercy Medical Group or the Woodland Clinic, for instance, can continue to pay in-network rates for their care until June 30. Then, those contracts also would expire.
▪ Patients who get their care through the Dignity Health Medical Network in Ventura and through Dignity Health Medical Group St. Francis/St. Mary’s in San Francisco will see no change in rates as a result of this dispute. This includes care received at Saint Francis Memorial Hospital, St. Mary’s Medical Center, SFO Clinic, and Sister Mary Philippa Clinic.
Need more information? Call Aetna at the phone listed on the back of your insurance card, visit www.DignityHealth.org/aetna or call Dignity Health at 877-729-2669.
