A contract dispute between Piedmont Healthcare and insurance giant Aetna could force some Georgians to hunt for new doctors or pay higher out-of-network fees if an agreement isn’t reached by Monday.
The main disagreement is over rates, said Aetna spokesman Walt Cherniak, who declined to discuss specific numbers.
“We’re very hopeful we’re going to be able to reach a resolution before this goes to termination,” Cherniak said.
It’s unclear how many people might be impacted if the agreement is terminated, said Cherniak, adding that Aetna has between 500,000 and 600,000 customers in Georgia with the bulk residing in metro Atlanta. “It’s a disruption we’re trying to avoid.”
The contract includes all four of Piedmont’s hospitals and more than 700 physicians. Both Aetna and Piedmont have sent notification letters of the impending Jan. 31 deadline to patients.
According to Piedmont officials, hospitals and health systems routinely renegotiate contracts with insurers, often coming down to the last minute before settling.
“We are working diligently to renegotiate this contract on behalf of our four hospitals and physicians without creating undue anxiety or worry for our patients,” Piedmont said in a statement.
A growing number of consumers are opting for high-deductible plans, which means more money out of their pockets, so rate hikes are hitting them directly, Cherniak said. “We are in the position of having to contain rising medical costs for our customers.”
A contract termination would likely mean that starting Feb. 1, patients would need to look for a new doctor or pay out-of-pocket to see Piedmont physicians out-of-network, Piedmont said.
Both sides remain optimistic an agreement will be reached. “We want to get a deal done,” Cherniak said. “Piedmont wants to get a deal done.”
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