Aetna and Novant at impasse over health cost increases [The Charlotte Observer, N.C.]

May 11--Aetna health insurance company is threatening to terminate its contract with Novant Health July 1.

If the two organizations don't come to an agreement on allowable charges for medical care, about 125,000 Charlotte-area Aetna customers could find themselves out-of-network, and paying more, to use Presbyterian Healthcare services.

"Our goal is to keep Novant in the network," said Mark Schmidt, market president for Aetna in the Charlotte area. But he said Novant is already "the most expensive" health-care system in the Charlotte.

Aetna sent about 3,000 letters to Presbyterian-affiliated doctors last week, and planned to meet Tuesday with representatives of its 25 largest employer customers to let them know about the potential contract termination.

Schmidt said Novant received a 7.7 percent increase in January, and is asking for another 13 percent increase in July and 7 percent more in July 2011. Novant's inpatient hospital charges are 18 percent higher than Aetna's N.C. average, and charges for outpatient services are 28 percent higher, according to figures supplied by Aetna.

Schmidt said Aetna's goal would be to provide no additional increase for Novant this year.

Novant spokesman Jim Tobalski said the hospital system is hoping to reach agreement with Aetna soon. He said the insurance company's decision to notify doctors, customers and the news media is a "tactic" designed to get public support.

"We're disappointed Aetna is trying to negotiate a contract publicly," he said.

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