Aetna patients could lose access to Duke Health by October, hospital says

DURHAM, N.C. (WNCN) — Patients covered by Aetna could lose access to Duke Health, the healthcare system said on Friday.

According to Duke Health, the healthcare system is involved in contract negotiations with Aetna to keep the insurance provider in its network as the two have been unable to reach an agreement.

“Aetna has not agreed to updated reimbursement rates that keep pace with rising health care costs and reflect the actual cost of providing patient care,” Duke Health said in a statement. “Their current proposal would limit Duke Health’s ability to invest in technology, staffing, and essential patient services, which puts our community’s continued access to high-quality care at risk.”

If an agreement is not reached, according to the healthcare system, patients covered by Aetna may lose access to Duke health doctors, hospitals, clinics, and services on Oct. 20.

“We are urging Aetna to prioritize our patients’—their members’—needs and allow them to keep their trusted Duke Health doctors in-network,” the healthcare system said in a statement.

Patients who receive care at Duke Health Lake Norman Hospital will not be impacted by the contract negotiations due the hospital having a separate agreement, according to the healthcare system.

Aetna issued the following statement on the negotiations:

“Aetna is committed to providing access to affordable, quality health care for our 1.5 million members in North Carolina. We are negotiating in good faith with Duke Health—a partner for several decades—to enable members to continue receiving in-network care at all of their locations.

“We have a responsibility to offer a cost effective, quality provider network to our customers. Payment to providers participating in our networks directly impacts health care costs and we have an established track record of working collaboratively with health systems in North Carolina toward fair and market-competitive reimbursement. North Carolina has among the highest health care costs in the country and Aetna is unwavering in our effort to protect our North Carolina members from additional escalations in costs. Our discussions are ongoing and our intent is to reach a mutually agreeable outcome with Duke Health.

“These negotiations have no impact on Aetna members accessing Duke Health today.”

Earlier this month, a similar warning came from UNC Health who has not reached an agreement with Cigna. If the three-year contract expires without a new deal, all Cigna members will lose coverage come Dec. 1.