AETNA II: HMO Stands Firm In Texas, Elsewhere
In response to last week's defection of 400 physicians affiliated with Genesis Physician Practice Association from Aetna U.S. Healthcare's Dallas-area HMO, Aetna "has retaliated by cutting off" the physicians' "access to all its Dallas patients." Aetna did so by invoking an "all products" policy, which "meant Genesis doctors who refused HMO patients would be denied access to patients in all Aetna plans." Thus, the conflict will now affect almost 30,000 Genesis patients.
The New York Times reports that Aetna is arousing the ire of doctors nationwide. "Aetna's perceived as the worst kid on the block," said Dr. Phil Berry, a Dallas orthopedist. Doctors have quit Aetna plans in Ohio, and "the Georgia Medical Association says that disgruntled doctors in Atlanta are threatening to follow." Paul Shanor, executive director of the Georgia physicians' organization, said, "What I'm hearing is take-it-or-leave-it negotiating." Nancy Gilette, a lawyer for the Ohio State Medical Association, said, "Over the course of the past year, their posture was one of 'we don't have to talk to you.'" Nevertheless, Aetna claims it is content with its position, as it "is enrolling physicians far faster than it is losing them." Dr. Arthur Liebowitz, Aetna's chief medical officer, said, "Overwhelmingly we have been successful in negotiating with doctors. But we won't agree with everybody, every time" (Kilborn, 10/20).