Sutter Health reaches deal with Aetna covering thousands of California patients
Sutter Health reached a contract for Aetna commercial members in Northern California and the central coast, days before the deadline, ensuring that thousands of patients will keep their doctors in network.
The current contract ends Monday.
The new agreement means that Aetna will continue to cover care for commercial HMO, EPO and PPO members who visit Sutter hospitals and clinics, the companies said in a news release.
Last month, Aetna sent letters to some HMO patients, warning that if a new agreement wasn’t reached, they would be reassigned to non-Sutter doctors. Sutter previously estimated that the contract affected 900 HMO members in the Sacramento area alone.
Negotiations between health systems and insurers are typically resolved behind closed doors, but occasionally escalate into public view. Another deal under negotiation this summer, between the University of California Health System and Blue Shield of California, has also drawn close to its expiration. That agreement covers about 35,000 people at UC Davis Health alone, including a large number of state workers. As of Friday morning, a new contract had not been announced, and Blue Shield of California and UC Davis Health did not immediately respond to a request for comment.
Experts say that such negotiations may be more likely to escalate now. Economic pressures facing hospitals and insurers motivate both to drive a hard bargain. For instance, inflation raised hospitals’ costs. Insurers are seeing patients use more medical care than expected. And employers, in an environment of general economic uncertainty and recession fears, are likely more sensitive to big premium increases.
Experts say that while the groups typically are able to reach an agreement, patients are left, in the meantime, to worry that their medical care will go out-of-network.
In a message to patients, Sutter said its new agreement will take effect Tuesday.
