UW Medicine and Aetna did not agree on a new contract before a June 1 deadline, meaning more than 50,000 patients could soon see increases in health care costs or potential provider disruptions.
The Seattle-based hospital system and health insurance company for months had been working to come to a deal on rates at which Aetna would reimburse UW Medicine for health care services, but both have claimed the other side came with unfair asks. The two-year contract expired Sunday.
Patients with Aetna plans will now likely have to pay more for health care services they receive from UW Medicine or switch providers, according to the hospital system. On Monday, UW Medicine notified about 53,000 people who had at least one visit with the health care system in the last two years, hospital spokesperson Susan Gregg said.
Despite the contract expiration, both organizations said negotiations will continue in hopes of reaching an agreement that keeps Aetna-insured patients in network at Harborview Medical Center, UW Medical Center-Northwest, UW Medical Center-Montlake, UW Medicine Primary Care and Urgent Care Clinics, and professional services provided at Fred Hutchinson Cancer Center.
Some Aetna-insured patients could be eligible for "transition-of-care" coverage, which applies on a case-by-case basis to people who are pregnant or actively receiving treatment, such as cancer care, according to UW Medicine. Patients with questions about that option should reach out to Aetna and ask for a "transition-of-care" form, the hospital said.
Those not eligible for that option and who can't afford higher out-of-pocket costs might have to transfer their care to a different provider who is in-network. For a list of in-network providers and to ask other questions, Aetna encouraged patients to call the number on the back of their member ID card.
UW Medicine hospitals will continue to treat emergency department patients regardless of their insurance status or ability to pay, the health care system added on its online information website. In most emergencies, state and federal laws ensure patients do not face additional charges when receiving out-of-network care, the hospital said.
While health care providers and insurers typically go through these contract discussions every few years, depending on the agreement, negotiations have seemed to increasingly play out in public recently. Last summer, Aetna and Providence went through similarly tense negotiations before reaching a deal a day or so after the previous contract expired.
At the time, Providence also said Aetna's proposed reimbursement rates didn't keep up with the rise in the cost of drugs, supplies and staff wages over the preceding few years. But insurers, in these situations, often counter with concerns that increasing rates will ultimately result in higher premiums for patients.
In 2023, during contract discussions between UW Medicine and Premera Blue Cross, the Mountlake Terrace-based insurer cited a desire to prevent costs from being transferred onto customers. That agreement was also ultimately settled before the prior contract expired.
In its negotiations with Aetna this year, UW Medicine said it's done "everything possible" to reach an agreement that's "financially feasible and in the best interests of our patients and our dedicated employees."
Aetna similarly said Monday that it "made every effort" to agree on a deal with the hospital system, but that UW Medicine continued to "demand unreasonable rate increases that would drive up healthcare costs for our members and local employers."
The hospital system, meanwhile, has said Aetna's reimbursement rates to UW Medicine are the lowest of any insurer.
"We are not alone; other health systems have also had difficulty reaching fair terms with Aetna and have ended their contracts with the multistate insurance company," UW Medicine said in a statement last week.
In a letter sent to patients Monday, UW Medicine CEO Tim Dellit said the hospital system remains committed to providing affordable care to all.
"We will continue to negotiate in good faith with Aetna to attempt to reach a fair and sustainable agreement — one that ensures continued access to high-quality care and is in the best interests of our patients," Dellit wrote.
UW Medicine emailed initial notices to patients in April, warning of the possible changes. A "large share" of the commercially covered patients have coverage through their employers, Gregg said.
Aetna confirmed in a statement that their members with UW Medicine providers could seek transition-of-care coverage to continue to see their current provider in-network "for a period of time."
Some patients might also be able to use out-of-network benefits or opt to pay out of pocket for their care, UW Medicine said. The hospital urged people with questions to contact Aetna.
The hospital also recommended that patients consider rescheduling their upcoming UW Medicine appointments if they want more time to explore options.
UW Medicine will continue to provide updates and details about what patients should expect at uwmedicine.org/aetna.
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