Adam Cohen, a doctor at the practice, which has 17 cardiologists and two internists, said the dispute was about reimbursement. He said the group had not had a raise since 2006 and was paid well below national average rates. While Aetna has agreed to pay more, he said, their offer is well below what the doctors seek.
"They really exhibited no willingness to negotiate in earnest," he said.
Aetna said it has a responsibility to save money for its customers. Its offer, said spokesman Walt Cherniak, reflects "medical trend" in the area and what other cardiology groups are being paid. The cardiologists' demands, he said, "have been unrealistic." Cherniak said Aetna wants to keep the group in its network.
Independence Blue Cross, the region's other major private insurer, had disputes last year that left two significant urology groups out of its network. Premier Urology Associates, which has eight doctors in Langhorne, left IBC in July after the company cut its rates, said Ravi Rajan, a doctor in the practice. IBC and Academic Urology, which has 48 doctors in multiple locations, terminated their contract Nov. 30. According to IBC, Academic served 12,300 of its members.
Bernie Lynch, senior director of payer relations for the Pennsylvania Medical Society, said that it was still rare for doctors to drop their contracts with insurers in Pennsylvania, but they had become more careful about signing anew. "They've become more astute about what's included and what the fee base is and how it's going to affect the practice," he said.
