Montefiore Medical Center works out 11th-hour contract deal with Aetna

Author: john willow

Author: john willow

A major Bronx hospital group last week averted a crisis that could have left tens of thousands of patients looking for new doctors.

Montefiore Medical Center, one of the city's largest hospital networks, reached an eleventh-hour deal with insurance giant Aetna just days before the last extension of its contract expired, according to sources close to the talks.

While details of the yet-to-be-finalized three-year deal were not made public, negotiations were so tough that Montefiore sent out 1,800 letters to patients covered by Aetna plans warning that without an agreement by midnight, Jan. 7, the hospital group could no longer accept their insurance.

As well, some 400 Montefiore employees could have been affected by the cutoff.

Aetna is one of the state's largest insurers, with about 47,000 customers in the Bronx alone, and Montefiore runs four hospitals across the borough.

In addition to its flagship 620-bed Moses Division and 106-bed Children's Hospital in Norwood, the Montefiore network includes the 396-bed Weiler Hospital of Albert Einstein College of Medicine in Morris Park.

In 2008, Montefiore acquired the struggling Our Lady of Mercy Medical Center in Wakefield, giving it a new lease on life as the new 369-bed North Division.

Together, Montefiore's hospitals annually log more than 85,000 inpatient stays - including over 7,000 births - and more than 255,000 emergency department visits.

With the anticipated passage of major health insurance reform by Congress, negotiations between insurers and hospitals are likely to grow even more difficult in years to come.

While insurance companies such as Aetna stand to gain millions of new customers, new regulations requiring coverage of preexisting conditions and limiting insurers' ability to drop customers with expensive ailments will squeeze the companies' bottom lines.

Meanwhile, hospital groups such as Montefiore should benefit from an expected drop in the number of uninsured patients seeking emergency room treatment - whose cost the hospital must absorb.

But urban hospitals like Montefiore that serve large numbers of Medicare and Medicaid patients, stand to take a financial hit as well as federal cost controls limit doctor reimbursements.About the Author:

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