Duke Health, Aetna Reach Deal To Continue Care For State Health Plan Members

Agreement Ensures Continued Access, Focuses on Affordability and Efficiency

RALEIGH — After months of stalled negotiations, Duke Health and Aetna have reached a new agreement that ensures continued in-network access for members of the North Carolina State Health Plan, officials announced this week.

The deal, finalized following what state officials described as “unprecedented steps” to prepare for a breakdown in talks, means that plan members will not have to change doctors or seek new care providers. Aetna serves as the third-party administrator for the state health plan, which covers over 750,000 teachers, state employees, retirees, and their dependents.

“We appreciate the steps Duke has taken to keep costs down for the Plan,” said State Treasurer Brad Briner. “We have worked hard to dig ourselves out of a massive deficit and needed help from all providers in the state to get that done. This deal represents Duke’s commitment to serve North Carolina and our members.”

Negotiations between Duke Health and Aetna began earlier this summer but made little progress until recently. With a potential contract lapse looming, the state health plan began developing contingency plans to transition members away from Duke if necessary.

The breakthrough comes as a relief to many, particularly those receiving specialized care within Duke’s extensive healthcare network.

“Our priority has always been the health of our Plan members,” said Thomas Friedman, Executive Administrator of the State Health Plan. “This deal with Duke is a major step forward to keeping our costs under control while also allowing our members to keep the doctors they have chosen for care.”

Officials also praised the efforts of Dr. Tom Owens of Duke Health for helping to find an “innovative solution” during the negotiations, and acknowledged Aetna’s role in maintaining its commitment to affordability.

Going forward, the State Health Plan says it will continue working with Aetna and other providers across North Carolina to manage rising healthcare costs and protect access to quality care for public employees and retirees.