Patients face uncertainty as University of Utah Health's contract with Aetna is unresolved

The University of Utah Health Orthopedic Center. U. Health is currently negotiating its contract with Aetna and told patients that if an agreement is not reached, it may no longer be in-network for Aetna plans.

The University of Utah Health Orthopedic Center. U. Health is currently negotiating its contract with Aetna and told patients that if an agreement is not reached, it may no longer be in-network for Aetna plans. (Ben B. Braun, Deseret News)


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SALT LAKE CITY — University of Utah Health is still negotiating its contract with Aetna, as the current contract lasts just over a month longer.

If an agreement isn't reached in the next month, it could lead to 30,000 patients no longer having the option to receive in-network care from their current provider.

"We hope to come to an agreement soon that prioritizes our patients and communities across Utah and the region," U. Health said in a statement.

U. Health published a notice for its patients warning them about the possibility of their contract not continuing past Jan. 31.

"We know this situation may be upsetting and confusing. Please know we are here to support you through any changes and will do everything we can to ensure you continue receiving excellent care," the update said.

Somer Love, a U. Health patient with Aetna insurance, said even if this mirrors the contract negotiations between U. Health and Regence BlueCross BlueShield last summer, where an agreement was reached days before the end of the contract, it would already have negative impacts on patients.

Love noticed an email five days before Christmas saying her doctor will no longer be in network. She was on the phone trying to get information from Aetna, the Cystic Fibrosis Foundation and U. Health for over three hours that day.

With cystic fibrosis, she said U. Health is the only place she can go — it has the only accredited center that is paired with Intermountain Primary Children's Hospital.

"I'm not a billionaire, so I can't always just pay the out-of-network," she said.

She is on a Medicare Advantage plan, so Love will be able to change her plan during the next few months during an open enrollment period from Jan. 1 to March 31. Because her chronic illness is unpredictable, she said she can't wait for the final hour to make a change and risk not being in-network during February.

If she is not on a program that includes U. Health in February and she does need to be hospitalized, Love estimated it could cost her about $500,000 to pay the 45% of her hospital bill required on her plan for out-of-network care. She said she is typically in the hospital for a few weeks.

She is working with Aetna to see if her chronic condition could qualify to allow her to stay in-network longer, but the review could take a couple of weeks.

U. Health said those receiving cancer treatment at the Huntsman Cancer Institute and those who are receiving pregnancy care for a baby due after Feb. 1 can likely continue receiving treatment at U. Health as if it were in-network "for a limited time," but they may need to apply as Love did.

In its notice to patients, U. Health encouraged Medicare Advantage members, like Love, to contact their agent for information about plans that do have access to U. Health and commercial members to contact their employer or Aetna for options to switch to other plans.

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Emily Ashcraft is a reporter for KSL.com. She covers issues in state courts, health and religion. In her spare time, Emily enjoys crafting, cycling and raising chickens.

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