Aetna to offer discount cards, starting in Denver, New Jersey

Aetna is moving into a business more associated with placards stapled to telephone poles than big health plans -- private-pay medical discount cards.

Vital Savings on Health would allow companies to offer their employees prepaid cards good for 10% to 50% discounts off the cost of routine health expenses, when payment is made at the point of service. The company said the discount represents the range of discounts under Aetna's PPO plans, and that physicians would not be expected to provide additional discounts. Physicians would call a toll-free number or check a Web site to determine the rates for various services.

Vital Savings on Health is not insurance. Christine Skelly, Aetna's vice president of health-related financial solutions, said Aetna will target employers who want to offer their employees some medical coverage, but just can't afford a traditional insurance plan. Money will be deposited into the debit card via contributions from employers and/or employees.

Skelly said Aetna is taking several steps to inform physicians about the program, including written communication and visits to physicians' offices by Aetna staff members. Aetna will require its member physicians to opt out of the program if they don't want to participate. Without that notice, they're in.

On the surface, Larry S. Fields, MD, president of the American Academy of Family Physicians, says Aetna's plan to offer consumers discounted medical services along with a prepaid debit card sounds like a good idea. But he said the opt-out provision reeks of the days when Aetna and other insurance companies included "all-products" clauses in their contracts, meaning physicians would be bound to all of an insurer's product offerings.

Still, Aetna's program appears to be more transparent than most discount cards because physicians have the opt-out option, said Matthew Katz, executive director of the Connecticut State Medical Society.

PPOs often rent their physician networks to other plans that offer the cards, drawing physicians in unwittingly by telling them they must accept the cards because they signed on to treat patients in the PPO and any "affiliated" plan.

Colorado Medical Society President Richard May, MD, said Aetna's program will only work if physicians aren't paying for it through additional discounts to their negotiated rates. Dr. May said many physicians in Colorado already provide discounts to uninsured patients who pay at the point of service.

"Most physicians that we work with recognize that there's a big problem with people not having insurance," Dr. May said.

Aetna's program has even sparked talk about an idea that had been discussed previously in Colorado, but was tabled years ago. Dr. May said the medical society would revisit the idea of posting, on its Web site, a list of physicians who offer discounts to cash-paying patients.

"If [Aetna's program is] simply a way to get patients to doctors who have acknowledged that they'll provide a discount, that could be a very positive thing," Dr. May said.

"If it's simply a way of cutting the physicians' reimbursement by promising they'll get paid faster, that doesn't help physicians. Here in Denver there's not much lower physicians can go and still stay in business," he said.

Aetna's new program is set to be offered to employers of all sizes beginning in September in Denver and southern New Jersey, and in October in Tampa, Fla., and Raleigh, N.C. Aetna said it plans to add additional markets in 2007.