Piedmont, Aetna settle contract dispute

Piedmont Healthcare and Aetna have reached an agreement on a new three-year contract, averting the possibility that many Georgians would have to choose new physicians and hospitals.

Many such contract negotiations between insurers and hospitals come down to the wire before an accord is reached, and it was true in this case. The agreement was announced Monday, hours before the midnight deadline.

Piedmont, based in Atlanta, issued a statement saying the accord ensures “that our patients and communities continue to have access to high-quality health care through choice of providers.’’

Aetna has 500,000 to 600,000 members in Georgia, mostly in metro Atlanta.

“This was not a particularly contentious negotiation,’’ said Aetna spokesman Walt Cherniak on Monday. “We were never that far apart.’’

Aetna has a contract with every major Atlanta hospital system, Cherniak said.

Piedmont and Aetna had informed patients of the looming Jan. 31 deadline. If a deal had not been reached, many Aetna members would have had to choose a new doctor or pay a much higher cost for out-of-network services delivered by Piedmont’s hospitals or doctors.

Piedmont has four hospitals: Piedmont Hospital in Buckhead, Piedmont Fayette Hospital, Piedmont Mountainside Hospital and Piedmont Newnan Hospital. The contract also includes more than 700 physicians in the Piedmont Clinic, Piedmont Physicians Group and Piedmont Heart Institute.

Both Piedmont and Aetna have fought high-profile contract battles in the past.

Piedmont and the state’s largest health insurer, Blue Cross and Blue Shield of Georgia, tangled in 2006 over a contract, with the dispute playing out in ads and in the media. An agreement was reached, but not until about a month after the previous contract had ended. The delay caused many patients to look for new doctors.

Aetna and Atlanta’s Northside Hospital clashed over contract restrictions before a deal was struck in 2001. Aetna had objected to Northside’s deals with insurers that excluded other hospitals in exchange for lower prices. The 2001 accord dropped the exclusivity provision, and Aetna agreed to pay ‘’premium pricing’’ to Northside.