UNC Health, Aetna can't agree on new contract
Posted January 19, 2011 4:42 p.m. EST
Updated January 19, 2011 6:21 p.m. EST
Chapel Hill, N.C. — About 10,000 Triangle-area residents could be forced to seek new doctors of pay more for medical care next month because of a dispute between UNC Health Care and Aetna.
The two sides can't agree on how much the insurer should pay for medical services. If they don't reach an agreement by Feb. 5, UNC Hospitals, Rex Healthcare and affiliated medical practices will no longer accept Aetna insurance.
"Here we are in the middle – the middle man – and we're just stuck," said James Archer, who recently added himself to his wife's insurance through Aetna instead of renewing his own policy at work.
Two years ago, doctors discovered a tumor in Archer's leg after a bike accident. He is now cancer-free but continues to go to UNC Hospitals for follow-up care with the same physician.
"He's handled my case the whole time, and I'm very pleased with the results," he said. "It's just kind of frustrating that I'm going to have to find a new doctor – someone knows nothing about my case."
If Aetna customers like Archer want to keep their UNC doctors, in most cases, they will have to pay out-of-network costs.
Aetna officials said in a statement that UNC wants "unreasonable increases" for its hospitals and physicians.
"Agreeing to them would significantly raise costs for Aetna customers who already are suffering under the strain of rising health care expenses," the statement said. "Aetna recognizes the importance of addressing this issue. UNC needs to do the same by coming to the table with a more realistic proposal."
Meanwhile, UNC Health Care officials said in a statement that they must demand comparable terms for all insurers.
"We take our responsibility to the people of North Carolina very seriously and very much regret that we have not been able to reach mutually acceptable terms with Aetna," the statement said. "We stand ready to help our patients however we can and will make every effort to enable care continuity with Aetna's patients."
The health care system is encouraging Aetna customers to call the insurer about their specific situations.