June 22, 2000
New Programs Add Flexibility and Choice for Virginians and Their Doctors
RICHMOND, Va., June 21 /PRNewswire/ -- Aetna U.S. Healthcare(R) today
announced new
programs and options for physicians and patients in Virginia, as part
of a companywide effort to
improve relationships with all of its constituents.
At a meeting with state and county medical society members, Aetna U.S.
Healthcare Capitol
Region Medical Director Dr. Bernard Slosberg outlined the following
new initiatives and policy
changes for physicians in Aetna U.S. Healthcare's Virginia networks:
* Flexibility for physicians to opt out of Aetna U.S. Healthcare's all- products policy;
* Fee-for-service payments instead of capitation for independently contracted primary care physicians with fewer than 100 Aetna U.S. Healthcare HMO members;
* Ninety days' advance notice of significant payment or administrative changes;
* Formation of a joint working committee with the Medical Society of Virginia to help us work more closely together on future initiatives.
"Aetna U.S. Healthcare is working hard to improve relationships with
physicians in Virginia,
and across the country," said Dr. Slosberg. "We hope to form a more
collaborative partnership
that makes the system work better for everyone."
"We're pleased to hear from Aetna U.S. Healthcare of their plans for a more patient-friendly and physician-friendly relationship," said Dr. Lawrence K. Monahan, President of the Medical Society of Virginia. The Medical Society is the largest organization of physicians in the Commonwealth, representing more than 7,500 doctors. "We applaud Aetna for this announced change in direction, and hope that it signals a new approach for managed care in Virginia."
In addition to the physician programs, Dr. Slosberg announced the following
changes for
Aetna U.S. Healthcare HMO members in Virginia:
* Expansion of external review of coverage determinations to include
pharmacy claims, standing referrals and emergency care. Aetna U.S.
Healthcare's current program applies to medical
necessity and experimental treatment coverage decisions;
* Elimination of certain referrals for laboratory and radiology services;
* Increased flexibility for women to use obstetricians/gynecologists as their principal physicians;
* The option to use specialists as principal care physicians for members with serious illnesses.
"Virginia welcomes Aetna U.S. Healthcare's efforts to make health insurance
more consumer-friendly for the citizens of the Commonwealth," said Claude
A. Allen, Health and
Human Resources Secretary.
The target date for completing implementation of the changes announced
today is January 1,
2001, although some will be implemented earlier. The ability to opt-out
of Aetna's all-products
policy, for example, will take effect July 1.
"There are compelling reasons for physicians and managed care organizations
to work together,"
said Jon Glaudemans, Aetna U.S. Healthcare's General Manager for Virginia.
"We share a
common goal, which is to ensure that the citizens of Virginia have
easy access to
high-quality health care facilities and services. We're looking forward
to working more closely
with Virginia physicians on these and other challenges in the future."
Aetna U.S. Healthcare, the health benefits unit of Aetna Inc. (NYSE:
AET), is the nation's
leading health and related benefits organization, providing a full
spectrum of products ranging
from health maintenance organizations (HMOs) to indemnity health insurance,
group life and
disability products, and dental, vision, and pharmacy benefits.
The company provides products and services to 19.5 million health, 11.5
million group insurance,
and 14.8 million dental members nationwide, including more than 500,000
members in Virginia.
To learn more about Aetna U.S. Healthcare, visit the company's website
at www.aetnaushc.com .
SOURCE Aetna U.S. Healthcare
CONTACT: Walt Cherniak of Aetna U.S.
Healthcare, 301-489-5136, or pager,
888-348-4246, or Cherniakjrw@aetna.com