While management of contracts between UTMB and various payors usually remains confidential, UTMB took action earlier today that could result in some media coverage. I wanted to let you know directly what we are doing and why we are doing it.

As of this morning, UTMB has notified Aetna that we intend to terminate our commercial insurance contract with the company in 180 days. This means we will no longer be an in-network provider for patients who have Aetna commercial insurance as of May 6, 2021. Aetna Medicare Advantage plans will not be affected. This action likewise does not affect UTMB employees who have their insurance through UT System (UT Select Plan administered by Blue Cross/Blue Shield.)

This is not a decision we made lightly. No decision regarding our patients’ health insurance is. But Aetna has not been paying a fair rate for the health care services UTMB provides. UTMB has worked in good faith since 2017 to negotiate more competitive terms. But Aetna has thus far been unwilling to do so.

As a public institution, UTMB has a responsibility to the public, to our patients and to our mission to be a good steward of resources. We can no longer afford to operate as an in-network provider under the current terms of the Aetna commercial contract.

We are notifying current UTMB patients who may have Aetna commercial insurance, so they will have ample time to speak with their employer’s benefits office and decide how they want to proceed. Those letters will include Frequently Asked Questions. We are distributing a brief press release as well.

We will still provide Emergency Department care as an in-network provider after May 6, 2021, and we can provide care for patients who choose to use out-of-network benefits after that date. We also will offer 90 days of in-network care after the contract ends for patients who are already undergoing a course of treatment at that time. During this three-month period, UTMB will work with Aetna to transition care to a new in-network provider for these patients. And we will, of course, work with any patient who decides to move to a new provider to ensure medical records are transferred in a timely manner.

We would welcome the opportunity to remain in Aetna’s network under mutually agreeable terms. But for the time being, we are focused on giving affected patients ample notice to explore other options and help them make a smooth transition if necessary.

Thank you and please keep up the good work of improving health in our communities.

Ben G. Raimer, MD, MA, FAAP
President ad interim