Aetna To Offer New Narrower Specialist Network To Certain Employers
Aetna officials announced Tuesday that the insurer will begin offering a new "narrower" network of specialists to certain employers in an effort to help control the cost of health care, the Hartford Courant reports (Levick, Hartford Courant, 10/1). The Aexcel network will include doctors in six specialties -- cardiology, cardio-thoracic surgery, general surgery, gastroenterology, orthopedic surgery and obstetrics and gynecology -- who were selected based on their "efficient use of health care resources," case volume and their "effectiveness against certain clinical measures," the AP/Albany Times Union reports. The medical specialties were selected because they represent a large percentage of health care spending, Aetna officials said (AP/Albany Times Union, 9/30). Aetna spokesperson Elizabeth Sell said that depending on the market, the specialists in the Aexcel network represent about 50% or more of the specialists in the broader networks for the six specialties. The new network will be offered as an option to self-insured employers. Employers will have the option of offering their employees only the Aexcel network for the six specialties or offering Aexcel along with Aetna's larger network. If both networks are offered, employees will typically be charged a higher copayment to see a specialist who is not in the Aexcel network, the Courant reports (Hartford Courant, 10/1). Don Liss, Aetna's senior medical director, said that the network will help lower medical costs by identifying and leading people to more efficient providers, the AP/Times Union reports (AP/Albany Times Union, 9/30). Sell said that the amount of money saved by using the Aexcel network will vary by health plan design and the market, the Courant reports (Hartford Courant, 10/1). Beginning Jan. 1, the Aexcel network will be available in the Dallas-Fort Worth area, western Washington state and north Florida, but Aetna officials expect the company to add other markets in 2004 and 2005 (AP/Albany Times Union, 9/30).
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