To restore its wounded image among angry physicians and hospitals in Connecticut, Aetna earlier this month announced friendlier managed care policies designed to resolve
financial concerns and restrictive "gatekeeping" complaints. The health plan offered changes and concessions to its controversial capitation requirements and "all-products
policy."
Under the relaxed guidelines:
- Connecticut doctors will be able to opt out of the restrictive all-products policy that required physicians to serve all of Aetna's health plans, not just the ones
they preferred; and - Physicians with less than 100 HMO members will be paid on a fee-for-service basis instead of the previous capitation arrangement that paid primary care physicians a set per-
member-per-month fee.
Last year the Connecticut State Medical Society (CSMS) denounced Aetna for policies it viewed as greedy and restrictive.
When William Donaldson took over as chairman and chief executive in February, one of his goals was to mend the health plan's frayed relationship with physicians. The guidelines
are considered an important first step toward that goal, says Tim Norbeck, CSMS' executive director.
Aetna's image woes are far from over. Several shareholders, incensed that the health plan spurned a $10 billion takeover by WellPoint Health Networks in March, have filed
lawsuits seeking class-action status.
(Aetna, Joyce Oberdorf, 860/273-7392)