State preparing for Duke Health-Aetna dispute to extend past deadline

Less than a month remains for two health care providers to reach a deal, or hundreds of thousands of state employees could be stuck paying more for their health insurance.

On Tuesday, the state treasurer warned that he is preparing for what happens if Duke and Aetna can't agree on a deal.

Those around the standoff are pressing leaders for solutions with time running out.

We are just under four weeks until that deadline when Aetna would drop Duke Health, which would put the pressure on patients to find a new provider. It's a situation that's too close for comfort for State Treasurer Brad Briner.

Only about 3 percent of the 700,000 state employees use Duke Health.

Briner said there’s a world where none of them would be covered if Aetna drops Duke Health. 

"We have begun to make preparations for them to leave the network," Briner said.

Plans in place because the State says Duke is not willing to absorb the rising cost of health care. 

Duke Health Executive Vice President, Dr. Thomas Owens, spoke to WRAL News last week about the ongoing negotiations with Aetna.

"I want to first be clear that this is a negotiation between Duke Health, a not-for-profit health system, and Aetna, a for-profit health plan," Owens said. "We are not in negotiations with the treasurer."

"We’ve not had a rate increase from Aetna in four years, despite remarkably challenging economic times for health systems with inflation for supplies, materials, goods and labor being remarkably high in the last four years."

Even with those difficulties, Duke Health, a non-profit hospital, made $600 million last year.

And has extensive coffers, totaling more than $4 billion in investments.

"Duke is more than fine with our existing rates, yet wants to play chicken with our members," Briner said. "This is not the kind of partner we need."

"We take a 5% draw every year that we use to support operational costs. The actual direct operations of the health system have required continued investment because our reimbursement has not kept up with the cost of care.

Duke Health and Aetna have a deadline of Oct. 20 to come to an agreement. Otherwise, those with Aetna would no longer be covered at Duke Health facilities.

Briner said the state health plan would protect those at most risk for a period of time.

"When Duke inevitably tries to escalate the situation and tries to tell you that we are risking our members' lives, know that is simply false," Briner said. "In fact, state law protects those who have severe conditions by allowing continuation of care."