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Novant Health has challenged information released yesterday by Aetna Insurance Company as inaccurate, misleading and part of an effort to increase the insurance company’s profits at the expense of hospitals, patients and Aetna’s own insurance subscribers. Novant officials contend Aetna’s effort is clearly intended to intimidate the healthcare system as the two companies have just started negotiations on a new contract.

“It is unfortunate that Aetna has chosen to launch a public misinformation campaign prior to sitting down to start of our routine contract negotiations,” said Bob Seehausen, Novant Health senior vice president. “Rather than make a good faith effort to negotiate a contract that is in the best interest of their members, Aetnaappears to be more interested in disparaging our health system than admitting it is willing to further restrict its member’s healthcare choices in order to stockpile huge profits before national healthcare reforms are implemented.”

Novant officials question the data released by Aetna, which incorrectly indicates the health system’s costs to provide care in the Charlottemarket area are higher than state and national averages.

“We monitor cost of care very closely through independent collection sources and know that our commercial prices at our Charlottefacilities are 2 to 4 percent below market averages,” said Seehausen. “We have asked Aetna to substantiate its data, which is based on its own company information. However, the information we have seen does not support Aetnaclaims.”

Additionally, Seehausen says that Aetnahas requested Novant take a 5 percent reduction from current reimbursement. Taking a 5 percent reimbursement reduction will put us even further below the state average from where we already are, he says.

Novant owns and operates facilities concentrated mainly in three states, and according to Seehausen is consistent in negotiating payor contracts in each market that attempts to avoid giving any one insurance company a price advantage over any other.

“We understand what Aetna is attempting to do, but it is our policy not to assist any payor in their efforts to take market share away from its health insurance competitors through inequitable pricing,” said Seehausen. “Our priority is to provide the best possible care at all of our facilities for the patients who choose to trust us. We will not compromise that priority for Aetnaor any other payor.”

In the last two years, Aetna has made $2.6 billion in profits.  In contrast, Novant Health has made $10 million in net income in the last two years while also providing $222 million in charity care for patients who were uninsured

“Aetna’s first quarter 10Q filing shows a loss ratio of 81.1%.  This means 19 cents of every member premium dollar is used for its administrative costs and profits,” said Seehausen. “This may also be a motivating factor behind Aetna’s current efforts to squeeze hospitals and healthcare providers because, under recently passed federal legislation to reform healthcare costs, administrative costs and profits for insurance companies will be capped at 15 cents for every premium dollar. This is putting pressure on insurance companies to find other ways to maintain or increase their profits. One of those ways is to squeeze hospitals and clinics that are already operating on very slim margins.”

“We are hopeful that Aetna will rejoin us at the negotiating table so we can find a solution that works for both of our organizations as well as our patients,” said Seehausen.