Aetna and Dignity Health Yavapai Regional Medical Group have until April 1 to reach new contract
Impasse does not impact Dignity Health YRMC hospitals in Prescott or Prescott Valley

With a looming deadline of midnight March 31, Dignity Health Yavapai Regional Medical Group and Aetna insurance have yet to negotiate a new in-network contract for their patients.

The contract does not impact Dignity Health Yavapai Regional Medical Center’s two hospitals in Prescott and Prescott Valley. The medical group includes about 300 doctors and medical providers in Prescott and Prescott Valley; these doctors are all affiliated with the two hospitals.

Just prior to the Easter weekend, Dignity Health and Aetna officials on Thursday afternoon admitted they have yet to create a new agreement to go into effect on Monday, April 1. Both sides, though, insist they intend to continue negotiations with the goal of reaching an equitable agreement that meets the interests of all parties. The patients impacted in these negotiations include those with both commercial and Medicare Advantage plans; the exact number of those locally has yet to be disclosed.

Aetna patients were alerted in mid-February of the chance that their doctors and medical practitioners within the Dignity Health Yavapai Medical Group might be opting out of an in-network contract with the national insurer as of April 1. In late February, Dignity Health Arizona and Aetna officials assured that they had high hopes of reaching a settlement prior to the deadline. To date, a contract has yet to be finalized, with both sides placing blame on the other.

Aetna is in similar contract negotiations with physicians and medical providers in Arizona, Nevada and California, according to new sources in those locations.

“Dignity Health continues to work with Aetna, and negotiate in good faith,” said Carmelle Malkovich, Dignity Health Arizona external communications director in Phoenix in a news release. “However, Aetna thus far has not proposed contract terms that would sufficiently help Dignity Health to sustain its mission.”

Aetna officials countered that they are seeking to avoid “unsupportable increases in reimbursement rates that would raise costs for our members and plan sponsors in the Yavapai County community.”

“We have a responsibility to our members and health plan sponsors to negotiate fair reimbursement rates,” said Alex Kepnes, executive director of communications for Aetna/Health Care benefits in a news release. “We remain committed to negotiating in good faith for a fair contract.”

This is not the first time Dignity Health YRMC patients have feared the loss of in-network insurance coverage due to negotiations over operational costs between the hospital and its providers and national insurance carriers.

One year ago, Blue Cross Blue Shield of Arizona and Dignity Health YRMC were in dispute over a contract that did not settle until the end of April when the contract was supposed to expire on April 1.

The three-year negotiated contract in that case was made retroactive to the beginning of the month.

Until Monday, Malkovich said Aetna patients are covered, and should be in contact with physicians and practitioners regarding any appointments or “plans of care.”

“We firmly believe in our responsibility to ensure that patients and our local communities continue to receive the care they rely on, and we will continue to work around the clock in hopes of reaching an agreement before the deadline on Monday, April 1,” Malkovich said. “We greatly appreciate the community’s support as we work tirelessly to support the well-being of our patients and this great community.”

Reach Nanci Hutson by email at nhutson@prescottaz.com or call 928-445-3333, ext. 2041.


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