Akron General Medical Center and health care for faculty at The University of Akron
You will have received a number of emails recently concerning The University of Akron, Apex, and the loss of Akron General as an in-network provider in 2016.
For your reference, here are links to copies of those messages:
October 2, 2015: From Nathan J. Mortimer on negotiations between Apex and Akron General
October 16, 2015: From Nathan J. Mortimer--AG informs UA that it will not continue in 2016 as in-network provider under Apex
October 21, 2015: From Tim Stover, President and CEO of Akron General on options available to UA to gain AG as in-network provider for 2016
October 26, 2015: From Nathan J. Mortimer---UA's response to letter from Akron General
Akron-AAUP Chief Negotiator Kevin Kreider’s and President John Zipp’s Update
Regarding Akron General Medical Center
November 2, 2015
On Thursday, October 29th, representatives from the Akron-AAUP and the University administration met to discuss the Akron General situation. We sought this meeting for several reasons.
First, as you may know, the President and CEO of Akron General, Dr. Tim Stover, sent an open letter to many University employees on October 21st. Dr. Stover stated he had conversations with University leadership regarding the issue of Akron General not being an in-network provider through Apex (the University’s current third party administrator (“TPA”)) effective January 1, 2016. Dr. Stover claimed that the University was aware for over a year that Akron General was not willing to be an in-service provider under Apex and that the University administration had represented to Akron General that the University would seek another or second TPA so that Akron General could remain in-network. We wanted to hear the University’s response to the letter, and to hear why it did not seek bids from other TPA’s to see if the in-network hospital systems currently available could be provided for 2016 at a reasonable cost.
Second, we reviewed the contract and addendum between the University and Apex and determined, in consultation with the Chapter’s outside healthcare experts, that the contract could be terminated by written notice on or before November 1st and, given the terms of the “runout” provisions, a substitute TPA could be found to offer the same in-network offerings for 2016. It was our position that such should occur.
As to the first issue, the University’s representatives stated that they knew in 2014 that the original contract between Apex and Akron General was only for two years, but the University’s representatives believed that a third year would be negotiated between the two parties for 2016. The University’s representatives stated that they were not aware until September of this year that Akron General would not renew its contract with Apex for 2016. We pointed out this was at odds with the claim made by Dr. Stover regarding the timing of when the University became aware of this problem. The University’s representatives acknowledged that the two positions were contradictory. To clarify this, Akron-AAUP has requested all relevant documents between the University and Apex, and between the University and Akron General, regarding this issue. The University’s representatives have stated that they will promptly provide those documents. To the extent any of those documents shed further light on the situation, we will so advise you.
The University’s representatives also made the following points. First, Apex is willing to continue with Akron General on the same terms and conditions for 2016 as existed in 2014 and 2015, but Akron General is unwilling to do so for a variety of business reasons. Second, in the spring of next year, the University will be seeking proposals regarding new TPA services to begin in 2017. Akron-AAUP has requested to be part of that process, and while the details need to be worked out, the University’s representatives gave us a positive response.
As to the second issue, the University administration has stated that it is unwilling to seek another TPA to replace Apex now, therefore Akron General doctors and facilities will be out of network in 2016. The University’s representatives gave three reasons for their unwillingness. First, the administration does not want an external dispute among local healthcare providers to dictate University healthcare decisions. Second, such a change would be economically disadvantageous to the University. Third, Apex has performed satisfactorily. We do not know if the second point is true or false, as that would depend upon what was negotiated with a different TPA. The third point is true, but there is no reason to think another TPA would not also be satisfactory, and such a change would be less disruptive to the extent such a new TPA would replicate the current in-network providers, which Apex will not be doing.
Finally, the University administration has indicated that the disruption will not be significant. According to the University, of the 181 Akron General affiliated doctors who are a part of the Akron Partner’s Physician group used by UA employees, only 46 will be out-of-network next year. This does not include doctors employed directly by Akron General. The administration will be distributing information across campus in the next few days, so you should be able to check whether your doctor will be in or out of network. You can ask your doctor to request in-network participation from Apex, although procedures done at Akron General facilities will still be charged at the out-of-network cost. Individuals who are currently in the middle of a course of treatment (for example, receiving chemotherapy) will be able to continue that treatment with Akron General at in-network costs. However, they must first contact Apex customer service to request continuation of care and there is a ninety (90) day limit to transitional care.
There inevitably will be problems or concerns that arise. If they do, the Chapter can assist you in resolving those problems and addressing your concerns. If you need assistance, please contact the Chapter’s Executive Director, Dr. Russ Davis, at 330.972.6131.
Click HERE for a printable copy of Akron-AAUP's update.
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