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Tens of thousands of Aetna members in Oregon will have easier, cheaper access to Providence Oregon hospitals and clinics after the large insurer and heath system reached a deal.
As part of a multi-year agreement, Providence Health & Services recently announced that its facilities in Portland and around the state were back in-network as of Dec. 1 for members of Aetna’s commercial plans.
This comes nearly a year after Aetna, a large health insurer owned by industry behemoth CVS Health, dropped Providence Oregon from its network when negotiations broke down due to a conflict over rate increases—the sort that have been roiling the health care industry as costs skyrocket.
“Providence will once again be a valued partner in our efforts to serve Aetna members in Oregon with access to high-quality, convenient care,” says Cathy Hughes, an executive for Aetna’s western region, in a written statement.
Still, the deal will take different forms in different parts of the state. Providence facilities will be in-network for Aetna’s commercial plans throughout the state. But only in Southern Oregon will Aetna’s Medicare Advantage have in-network access to Providence facilities.
An Aetna spokesman declined to share company membership data for Oregon, but government databases make some details available, and indicate Aetna’s Medicare Advantage market in Oregon is only a fraction of the size of its commercial market.
According to a federal dataset, about 5,000 people in the Tri-County area around Portland—and 14,000 in Oregon overall—are members of an Aetna Medicare Advantage plan.
Meanwhile, a state database indicates about 50,000 Oregon residents were as of Sept. 30 enrolled in one of Aetna’s commercial insurance plans. And more than 250,000 Oregon residents were members of self-insured plans—the sort run by large employers—of which Aetna is the administrator.
Aetna says the deal will be a boon for these members, too. “Self-insured customers fall under our Aetna commercial plans,” CVS Health spokesman Phillip Blando tells WW. “So Oregon residents on Aetna self-insured plans will now have in-network access to Providence.”
