The contentious negotiations between UConn Health and Aetna Inc. failed to reach an agreement before their contract expired this week.
Despite months of talks, the three-year contract expired at midnight Nov. 30, removing UConn Health from Aetna’s network for thousands of members.
In a statement issued Tuesday, UConn Health again stated it receives “some of the lowest commercial reimbursement rates of any hospital in Connecticut,” a key issue it raised throughout the negotiations.
UConn Health said it has negotiated in good faith with Aetna “to correct this long-standing disparity,” but that the insurer “has not offered rates that reflect the actual cost and value of the care we provide.”
In a presentation included with the agenda for the UConn board of trustees’ meeting on Monday, UConn Health officials said 24,509 patients overall are insured by Aetna, but that about 15,000 are directly affected by the contract expiring because the remaining 9,500 have “plans that enable them to continue at UConn Health even when out of network.”
However, Hartford-based Aetna Inc., which is owned by Rhode Island-based CVS Health, provided a statement Wednesday that noted that for some commercial members, “a two-month cooling-off period applies, and for those members UConn Health hospitals will remain at the in-network benefit level” until Feb. 1.
“This cooling off period does not apply to individual providers,” the Aetna statement said. “However, some members may qualify for continuity of care services for an extended length of time with their current providers.”
It added that state of Connecticut retirees may also have access to UConn Health through their Extended Service Area (ESA).
In response to a question from Hartford Business Journal, UConn Health responded that the state-required 60-day grace period “applies only to patients in Aetna fully insured (payor-funded) plans sold in Connecticut.”
It added that self-funded (employer-funded) plans and federal government plans, including Medicare Advantage, “are exempt as they do not mandate a grace period. As a result, no patients qualify for the grace period.”
Aetna’s statement also said UConn Health continues to demand “significantly higher reimbursement rates,” and that its proposal would “substantially increase” healthcare costs for members.
The insurer noted that nearly all Aetna commercial clients are self-insured, “which means 100% of the cost of care is paid directly by these employers and their employees.”
Aetna said it has also negotiated in good faith, and that it continues “to await a reasonable proposal from UConn Health and the opportunity to engage in a collaborative dialogue.”
UConn Health said it remains hopeful “that Aetna will return to the table with a fair, sustainable proposal so we can restore in-network access as quickly as possible.”
The presentation UConn Health prepared for the trustees also noted that its contract with United Healthcare, covering more than 27,000 patients, is due to expire on Jan. 31, while its contract with Cigna, affecting 14,000 patients, expires at the end of April.
