July 7, 2003

Emory, Aetna reach agreement

By Sylvia Wrobel

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.