Members of Toledo, Ohio-based ProMedica Physician Group said low rates are the main sticking point in an ongoing contract spat with Aetna, according to The Blade.
Beginning Jan. 1, ProMedica physicians will be considered out-of-network for commercial Aetna members, who will be billed 100 percent for any services received. Aetna's Medicare Advantage members will maintain in-network access to the physicians until June 1. Impending network changes could disrupt care the group's 950 salaried physicians provide to some 27,000 Aetna members.
Rates are a cornerstone of the physicians' stronghold, as the group said it hasn't received a rate increase from Aetna in six years. James North, MD, a salaried family practitioner with ProMedica Physicians Group, told The Blade Aetna pays the lowest rates compared to other local and national commercial payers.
Aetna told The Blade Dec. 8 it is "in active negotiations with ProMedica and hope[s] to reach a new contract that is fair and reasonable for our members and the ProMedica System."
ProMedica hospital and ancillary care will remain covered by Aetna even if a deal collapses.
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