Aetna insurance contracts expire at Fort Hamilton, West Chester hospitals

HAMILTON — Fort Hamilton Hospital patients who have Aetna insurance will see no change in their costs, even though the hospital says it is now an out-of-network provider.

Fort Hamilton and West Chester Hospital are under the authority of UC Health in negotiations with Aetna over their contract that, according to Aetna, expired at the end of 2010. UC Health is the successor to the former Health Alliance of Greater Cincinnati system, of which Fort Hamilton was a member. West Chester Hospital, which is part of UC Health, had no comment on the issue.

Although Fort Hamilton is now part of the Kettering Health Network, it remains under UC Health’s contracting authority until Aug. 1.

“We will inherit the penalty,” said Marielou Vierling, Fort Hamilton spokeswoman. “Based on today’s health care environment, it’s not feasible to accept no rate increase or rate reduction from commercial payers.”

Aetna would like to have UC Health in its network at rates that are mutually agreeable, Aetna spokesman Scot Roskelley wrote in an e-mail.

Fort Hamilton announced it was leaving Health Alliance in 2009 and later merged with Dayton-based Kettering Health Network.

Bryan Weber, Kettering Health Network director of contract management, said none of Fort Hamilton’s contracts with third party payers such as Aetna, Anthem Blue Cross and Blue Shield and UnitedHealthcare are yet under Kettering Health’s contracts. UC Health still performs operational functions such as billing and filing claims for Fort Hamilton, Weber said.

There are three possible outcomes, Weber said: UC Health reaches a new agreement that includes Fort Hamilton; Kettering Health reaches an agreement to include Fort Hamilton in its contract with Aetna and keeps UC Health in the loop; or no agreement is reached and Fort Hamilton remains an out-of-network provider.

Weber anticipates the Hamilton hospital will roll into Kettering Health Network’s Aetna contract at some point, possibly before year’s end, he said.

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