SAN MATEO: IPA Rejects Aetna Contract, Will Continue To See Patients
Six hundred San Mateo County doctors have canceled their contract with Aetna U.S. Healthcare effective Jan. 1, charging that the insurer's final reimbursement offer to their Independent Practice Association (IPA) was "insufficient." The San Francisco Chronicle reports that physicians in the San Mateo IPA are continuing to see their 20,000 Aetna patients despite the lack of a contract. Aetna spokesperson Bobby Pena said "the IPA's doctors are ... getting paid under temporary contract provisions 'while we work things out in January.'" The breakdown in the contract negotiations came as the doctors charged that Aetna "wasn't paying enough for them to provide quality care." San Mateo IPA Administrator Lisa Kraymer said, "I can tell you we've taken a 24% real decrease over the past five years. If you factor in the medical cost inflation it amounts to a 47% real decrease in compensation." The Chronicle reports that Aetna has been lobbying individual doctors to desert the IPA in favor of one of the two area IPAs with a current Aetna contract. Aetna West Coast Manager Tom Williams said, "We tried very hard to come to terms. Our priority now is to assure continuity of care for our members so they don't get caught in the middle of this situation."
Albert Holloway, president of the Oakland-based IPA Association of America, noted, "This is the largest contract any doctors' group has walked away from in California." He predicted the current standoff "is the beginning of what you'll see in the rest of the state and the country." The Chronicle reports that "[i]ndustry watchers say there are at least one or two large Bay Area medical groups that have been pushed to the brink of insolvency by the same pressures that made the 600 doctors of San Mateo IPA reject the Aetna contract" (Abate, 1/12).