Emory Healthcare (EHC) and Aetna announced this
week that they have reached an agreement that will enable Aetna
members to continue using Emory Healthcare services on an in-network
basis.
In April the two institutions had come to an impasse in negotiations,
and EHC announced it was terminating participation as a provider
of health care services for Aetna effective at the end of the calendar
year.
This successful resolution of issues changes that. It means that
EHC will continue, without any interruption of service, to be an
in-network participating provider for those who have insurance coverage
through Aetna.
“We are pleased that we were able to reach agreement in a
way that will allow us to offer our services—including highly
specialized services unavailable elsewhere in Georgia—to all
of Aetna’s members, while maintaining the quality of care
we provide at Emory,” said Patrick Hammond, EHC senior director
of managed care and employee support services.
Letters now are being sent from EHC President and CEO John Fox to
Emory Healthcare patients and parents of patients covered by Aetna.
The message: Emory will be able to continue its doctor-patient relationship
with them under their Aetna coverage. Fox called the agreement “a
win-win situation for us all, especially for Georgia patients.”
There’s also a message for employees in this. In April, when
it seemed certain EHC was not going to participate as a provider
for health care services for Aetna, University and EHC employees
enrolled in Emory Choice were told that another company would be
chosen to manage that plan. The new agreement means that Aetna will
be considered as plan manager for Emory Choice next year, as well.
(A committee meets every year to look at all the health care plans
available to employees and decides on the best payors to manage
each of those plans.)
Decisions about management of the plans for next year soon will
be made shortly, and Alice Miller, vice president for Human Resources
for the University, and Peg Bloomquist, senior director of Human
Resources for EHC, will inform their constituents of what is decided.
In the meantime, employees are covered just as they were and do
not need to do anything. During Open Enrollment this fall, employees
will be able to continue with Emory Choice (under Aetna management
or whichever company is selected) or choose any of the other available
health plans exactly as they have done in the past.
University employees with questions about their health plans can
call the HR benefits office at 404-727-7613, and EHC employees can
call their benefits office at 404-778-2626.
The new four-year contract between EHC and Aetna encompasses all
covered hospital services at Emory Hospital, Crawford Long, Emory-Adventist
Hospital and Wesley Woods Center, as well as professional services
delivered by approximately 1,000 EHC physicians at locations throughout
the Atlanta metropolitan area.
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