WHY I DROPPED AETNA
Aetna had been a poor payer for us since 1995, but their fees finally dropped so low that I had no choice but to resign from the plan as of February 1, 2002.
To illustrate the severity of the problem, here's a graph that shows the steady decline of Aetna's average payments to us over the past 9 years. Under the terms of the managed care contracts, doctors are forbidden from revealing the details of a company's fee schedule; so I've used some simple arithmetic to make the problem clear to you. I arrived at these numbers simply by having our computer add up the total dollar amounts we received from Aetna during each of these calendar years and then dividing that total by the total number of charges we submitted to Aetna, all of them, large (physical exams) and small ($1-2 incidental charges).
Stated another way, in 1993 Aetna lured all of us doctors into their plan by promising us a fee schedule that yielded an average fee of $35 for all charges as shown above. Over the intervening years they have steadily shaved their fee schedule so that the average fee now is a mere $19, a drop of 46%! And, of course, overhead (rent, staff salaries, malpractice insurance, supplies, etc.) has continued to increase steadily during this same period.
Could your business have stayed afloat for the past 9 years if your gross receipts had fallen 46% while overhead soared? Obviously not! Or think of it this way, if your employer had cut your salary by 46% over the past 9 years, wouldn't you and your co-workers have either quit or gone on strike? Of course you would.
And yet your doctors have stayed on the job for you, absorbing all the pain themselves.
Well, for this doctor, the Aetna component of the pain has now ended. I have no doubt that the most caring, concerned, and thorough of my colleagues, those who are absolutely determined to maintain a high standard of care for their patients, will eventually feel compelled to drop Aetna as well, leaving behind only the lowest paid doctors to care for Aetna's patients.
QUESTION:
Aetna's ads claim that their patients receive excellent care.
If so, then why does Aetna now feel the need to pay cash incentives to doctors for "Quality Enhancement"?
I am pleased that most of my long-time Aetna patients have chosen to stay with me.
For more information about the extent of the managed care debacle, please read what I've written about each of the other major managed care companies.
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