Providence is no longer in-network for Oregonians enrolled in Aetna plans amid lengthy contract negotiations between the two.
The contract between Aetna and Providence expired Jan. 1, meaning most of the system’s medical groups, hospitals and clinics are now out-of-network. Aetna’s contract with Providence Medical Groups, located in the southern part of the state, expires Feb. 17.
In a post on its website, Providence said contract talks have been ongoing “for months.”
“Negotiating for market-competitive and sustainable reimbursement rates is a priority for Providence to cover the cost of care for our patients with Aetna insurance, and to pay our doctors, nurses and caregivers for the essential services they provide,” the system wrote in the post.
Providence had not responded to a request for comment at the time of publication.
In a statement to Fierce Healthcare, Aetna said Providence was “demanding price increases higher than the market rate” to re-up the contract. Increased rates could cause financial challenges for members and businesses, as 85% of Aetna members in the Beaver State are enrolled in self-funded employer plans.
“These higher prices would lead to substantially higher out-of-pocket costs, deductibles, and copayments for our members and impact local employers and small businesses as well,” the insurer said. “We want to reach an agreement that brings Providence back into our networks and have offered them market competitive rate increases, but we cannot agree to terms that would burden local businesses and their employees with significant cost increases.”
For patients who have coverage through Aetna, Providence’s post urged them to reach out to the insurer directly or their plan sponsor to express concern. Aetna also encouraged members to contact the insurer if they need support.
The Oregonian reported that about 9,000 members would likely be affected across the state.
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