Doctors Still Wary About Aetna Transformation
Doctors Still Wary About Aetna Transformation
Despite the insurer's recent decision to drop its controversial all-products clause, doctors remain skeptical about a new, physician-friendly Aetna.
Doctors across the country are welcoming recent overtures made by the nation's largest health insurer to improve relations between the two groups. National policy changes, new management and regular meetings with state medical societies are all part of the "new" Aetna U.S. Healthcare's philosophy toward physicians. Still, the insurer appears to have its work cut out in restoring physicians' trust and easing bitterness following years of acrimonious dealings.
"It's a step in the right direction, I'll give them that," said Joy Maxey, MD, president of the Medical Association of Georgia (www.mag.org). Meetings with Aetna representatives over the past year have produced some positive changes in the contracts they offer physicians, she said, but she remains unconvinced that the insurer has undergone fundamental change.
"Nine months down the road, if we see a consistent pattern, I may have a different opinion," she said.
Her skepticism is echoed throughout the medical profession, despite the glowing publicity Aetna (www.aetnaushc.com) has garnered for its new "physician friendly" management and policies. In December, the insurer announced it was "relaxing" its requirement that doctors wanting to see Aetna patients had to participate in all Aetna plans, a policy known as an all-products clause that defined Aetna's attitude for many physicians. Although changing that "take-it-or-leave-it" image will take some time, many doctors agree the insurer is moving in the right direction.
"I think they realize that it's to their benefit to have better relationships with physicians, and with patients, too," said Walter Kahn, MD, president of the Medical Society of New Jersey (www.msnj.org).
Improving physician relations has been a stated goal of Aetna's new president and CEO, John W. Rowe, MD, who assumed his leadership role last September. The fact that he is a physician is not lost on other doctors, many of whom have seen a change in direction at Aetna.
"I feel that they are listening to us," said Dr. Kahn. "We were instrumental in getting them to change their minds on all-products." In fact, even before the December announcement about the nationwide policy change, Aetna representatives had been negotiating with various state medical societies, and in some cases made even further concessions to the separate doctor groups.
"This doesn't mean that they're going to give us everything that we demand," Dr. Kahn quickly pointed out. For example, the insurer continues to reject the group's request to cover pharmaceutical aids for smoking cessation, he said, and payment levels for physicians also are a perennial issue.
"They do drive a hard bargain with us in terms of fees," Dr. Kahn said.
Some physician complaints against Aetna are the same ones they lodge at all managed care companies. But Aetna, which did not respond to requests for an interview for this article, does appear to be gradually shedding its image as the most tight-fisted and vindictive.
"We hope that it is a real change, and that it serves as a stimulus for other health plans," said Peter Warren, director of media and public relations for the California Medical Association. (www.cmanet.org). That group has had extensive negotiations with Aetna leaders, producing a "blueprint for a productive relationship" that other managed care companies also are reviewing, he said.
Although the CMA still has significant issues to resolve with Aetna, the insurer's changes in top management and particularly its appointment of a physician leader are good signs, Warren said.
"One would assume that with that came a decision to become more consumer- and doctor-friendly," he said. "Down the road, the proof will be in how they behave."
Despite the insurer's recent decision to drop its controversial all-products clause, doctors remain skeptical about a new, physician-friendly Aetna.
Doctors across the country are welcoming recent overtures made by the nation's largest health insurer to improve relations between the two groups. National policy changes, new management and regular meetings with state medical societies are all part of the "new" Aetna U.S. Healthcare's philosophy toward physicians. Still, the insurer appears to have its work cut out in restoring physicians' trust and easing bitterness following years of acrimonious dealings.
"It's a step in the right direction, I'll give them that," said Joy Maxey, MD, president of the Medical Association of Georgia (www.mag.org). Meetings with Aetna representatives over the past year have produced some positive changes in the contracts they offer physicians, she said, but she remains unconvinced that the insurer has undergone fundamental change.
"Nine months down the road, if we see a consistent pattern, I may have a different opinion," she said.
Her skepticism is echoed throughout the medical profession, despite the glowing publicity Aetna (www.aetnaushc.com) has garnered for its new "physician friendly" management and policies. In December, the insurer announced it was "relaxing" its requirement that doctors wanting to see Aetna patients had to participate in all Aetna plans, a policy known as an all-products clause that defined Aetna's attitude for many physicians. Although changing that "take-it-or-leave-it" image will take some time, many doctors agree the insurer is moving in the right direction.
"I think they realize that it's to their benefit to have better relationships with physicians, and with patients, too," said Walter Kahn, MD, president of the Medical Society of New Jersey (www.msnj.org).
Improving physician relations has been a stated goal of Aetna's new president and CEO, John W. Rowe, MD, who assumed his leadership role last September. The fact that he is a physician is not lost on other doctors, many of whom have seen a change in direction at Aetna.
"I feel that they are listening to us," said Dr. Kahn. "We were instrumental in getting them to change their minds on all-products." In fact, even before the December announcement about the nationwide policy change, Aetna representatives had been negotiating with various state medical societies, and in some cases made even further concessions to the separate doctor groups.
"This doesn't mean that they're going to give us everything that we demand," Dr. Kahn quickly pointed out. For example, the insurer continues to reject the group's request to cover pharmaceutical aids for smoking cessation, he said, and payment levels for physicians also are a perennial issue.
"They do drive a hard bargain with us in terms of fees," Dr. Kahn said.
Some physician complaints against Aetna are the same ones they lodge at all managed care companies. But Aetna, which did not respond to requests for an interview for this article, does appear to be gradually shedding its image as the most tight-fisted and vindictive.
"We hope that it is a real change, and that it serves as a stimulus for other health plans," said Peter Warren, director of media and public relations for the California Medical Association. (www.cmanet.org). That group has had extensive negotiations with Aetna leaders, producing a "blueprint for a productive relationship" that other managed care companies also are reviewing, he said.
Although the CMA still has significant issues to resolve with Aetna, the insurer's changes in top management and particularly its appointment of a physician leader are good signs, Warren said.
"One would assume that with that came a decision to become more consumer- and doctor-friendly," he said. "Down the road, the proof will be in how they behave."
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