Aetna Chairman William H. Donaldson Speaks At Connecticut Medical Society Annual Meeting; Announces Changes to Improve Relationships with Physicians and Access to Care for Patients.

Business Editors

HARTFORD, Conn.--(BUSINESS WIRE)--May 10, 2000

Aetna Chairman and CEO William H. Donaldson announced new programs and options for physicians and patients in Connecticut today at the annual meeting of the Connecticut State Medical Society (CSMS). Among the changes: Connecticut physicians will have the flexibility to opt out of Aetna U.S. Healthcare's all-products policy and those with fewer than 100 HMO members will be paid on a fee-for-service basis instead of capitation. In addition, Aetna U.S. Healthcare HMO members in Connecticut will have access to expanded external review of coverage decisions.

"These changes are just the beginning of our efforts to improve relationships with physicians and, indeed, with all our constituents," Donaldson said. "My fervent hope is that we can form a more respectful and collaborative partnership that makes the system work better for everyone."

"Mr. Donaldson's comments represent a significant first step," said Tim Norbeck, executive director of CSMS. "We believe that this is an indication that Aetna is sincere about wanting to reach out and partner with physicians. We look forward to working with Aetna to achieve this important objective."

The announcement includes the following new initiatives and policy changes for physicians in Aetna U.S. Healthcare's Connecticut network:

-- More flexibility for non hospital-based physicians to choose the type of health plan in which they will participate.

-- Fee-for-service payments for independently contracted primary care physicians with fewer than 100 Aetna U.S. Healthcare HMO members.

-- Ninety days' advance notice of significant payment or administrative changes.

-- Appointment of a CSMS-nominated member to the Aetna U.S. Healthcare Connecticut Quality Advisory Committee.

In addition, the announcement includes the following changes for Aetna U.S. Healthcare HMO members in Connecticut:

-- Expansion of external review of coverage determinations to include pharmacy claims, standing referrals and emergency care. The current program applies to medical necessity and experimental treatment coverage decisions.

-- Elimination of referrals for laboratory and radiology services.

-- Increased flexibility for women to use Ob/Gyns as their principal physicians.

-- The option to use specialists as principal care physicians for members with serious illnesses.

The target date for completing implementation of the changes announced today is January 1, 2001.

"There are compelling reasons for us to work together. We are partners in a system that meets an important societal need," Donaldson said.

"There are major national issues that need attention -- including the 44 million uninsured and the increasing health needs of an aging population. There also are new demands for choice, flexibility and simplicity from consumers, employers, doctors and hospitals.

"At Aetna, we see a new Web-based model emerging that will give consumers more information and freedom to choose health care services. This requires a close partnership between health plans and physicians to facilitate the efficient delivery of high-quality, patient-centered care.

"In fashioning our response to the changes, we're starting from ground zero. We intend to work closely with physicians, employers, patients and government officials on a market-by-market basis as we build our strategy, business models, practices and operations going forward," Donaldson said.

Aetna U.S. Healthcare is the health benefits unit of Aetna Inc. (NYSE:AET). The company provides a full spectrum of products ranging from health maintenance organizations (HMOs) to indemnity health insurance, and dental, vision, and pharmacy benefits to approximately 29 million Americans, including approximately 311,000 members in Connecticut. Information about Aetna U.S. Healthcare is available at www.aetnaushc.com.