By Carol M. Ostrom, The Seattle Times Knight Ridder/Tribune Business News
Feb. 6--Some 60,000 Puget Sound residents with health insurance through Aetna heaved a sigh of relief as the insurer and Swedish Health Services announced yesterday they have reached agreement over reimbursement rates.
Neither side would reveal details of the new contract. Dr. Donald Storey, medical director for Aetna's Seattle market, characterized the agreement as a collaborative effort.
'It was a long and hard negotiation,' he said. 'Everyone gave a little.'
Ron Sperling, Swedish's chief financial officer, agreed. 'Neither of us got exactly what we wanted.'
In August, Swedish served notice to Aetna that its physicians would no longer see Aetna-insured patients nor would it care for them at its facilities, which include Swedish Medical Center/Providence Campus and the Providence Medical Group.
The termination was only the second time in Swedish's 91-year history that the provider failed to reach agreement with an insurer, said Sally Wright, a Swedish spokeswoman.
Swedish physicians make up about 20 percent of Aetna's physician network. Aetna-insured patients make up only about 5 to 6 percent of Swedish's non-Medicare/Medicaid business, Wright said.
Aetna subscribers should receive notices from the insurer informing them that they may return to their previous physician, if they already have switched, Storey said.
Swedish also plans to send notices to physicians and patients, Wright said, asking them to check with Aetna or their employer to understand their options.
Storey and Sperling differed drastically yesterday when recounting the history of the dispute.
Storey said Aetna was taken by surprise at Swedish's opening salvo last year -- simply terminating the contract.
'There was no communication before that. It was a new approach to negotiation,' he said. 'They're a very important hospital to our system, definitely perceived as such, and rightfully so, but they have a lot of power.'
When negotiations began in October, Storey said, Aetna wanted to make sure such an abrupt termination didn't happen again.
But according to Swedish's Sperling, Storey's version of events 'isn't even close.'
'There is no way that Swedish would do something like that,' he said. 'That's not part of our business ethics.'
In fact, Sperling said, Swedish began moving toward negotiations last April, 'putting (Aetna) on notice that we wanted to talk.'
In June, the two organizations began 2 1/2 months of 'very engaged negotiations.' But in early August, Swedish informed Aetna that it would terminate the contract within two weeks if something wasn't worked out.
In the third week of August, Sperling said, Swedish terminated the contract.
The current contract runs until January 2004.
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(c) 2002, The Seattle Times. Distributed by Knight Ridder/Tribune Business News.
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