For months, Providence has been actively negotiating with Aetna in Washington for fair and equitable reimbursement rates to provide ongoing care for our patients with Aetna insurance. Unfortunately, we have not yet come to an agreement, meaning our commercial contract with Aetna expires on Sept. 1, 2024, if a new contract is not reached.
These negotiations apply to ministries and services for the whole state, including Providence Health & Services – Washington, Swedish Health Services, Kadlec Regional Medical Center, PacMed Clinics, Health Connect Partners, LLC, and Inland Northwest Health Services.
Aetna has begun notifying brokers, employers, members, physicians and others that their members in Washington will be out of network at Providence on Sept. 1 if we do not come to agreement.
Please note: Caregiver benefits for the Providence family of organizations are not impacted by these negotiations regardless of their outcome. While these negotiations apply to Aetna's commercial networks in general, the potential termination does not apply to Aetna's Whole Health Product, which represents a small portion of Aetna's commercial membership. These negotiations also do not impact patients covered by a Medicare Advantage plan with Aetna at this time.
We know that this is a significant change for every impacted person if an agreement is not reached. Providence cares deeply about the people we serve and does not take potential terminations lightly. At the same time, we cannot continue to absorb the increased costs required to provide high-quality care without adequate, timely reimbursement rates for the services we provide and with continued denials of needed care.
Our health care costs – including pharmaceutical drug prices, supplies and what hospitals and clinics must pay employees to maintain adequate staffing levels – increased 26% between 2019 and 2023 and have only continued to rise. Like other health systems across the country, Providence has experienced major monetary losses as revenue and reimbursement fail to keep pace with the heightened costs of caring for patients.
Providence is working tirelessly to combat the rising costs of care, yet we cannot do it all on our own. Our partners in health care also need to be part of the solution. That is why you may hear more about several contracts we plan to renegotiate in Washington throughout 2024 and into next year. Our goal is to make decisions that allow us to provide the best care to our patients and fulfill our Mission of serving all.
Meanwhile, Providence remains in network for the vast majority of other commercial insurance plans. Patients can learn more about how to obtain assistance from Providence with their out-of-pocket costs by visiting providence.org/financialhelp.
We appreciate your patience and understanding during these negotiations and will keep you apprised of their developments. If you receive questions from patients about their Aetna insurance coverage, please encourage them to contact their insurance plan directly for more information.
Thank you for continuing to deliver high-quality, compassionate care for each person we serve.
