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Children’s Hospital resolves tiff with Aetna

Aetna had threatened to end coverage of care at Boston Children’s over what it said were exorbitant payments for a doctors group.
Aetna had threatened to end coverage of care at Boston Children’s over what it said were exorbitant payments for a doctors group.Jessica Hill/AP/FILE

Boston Children’s Hospital and Aetna Inc. said Thursday that they have resolved a dispute over reimbursement rates, avoiding what could have been a disruptive change for thousands of people.

“We look forward to our continued relationship with Boston Children’s,” Aetna spokesman Walt Cherniak said.

The state’s dominant pediatric hospital and the country’s third-largest insurer had planned to end their contract in February, meaning Aetna would largely stop paying for medical care its members received at Children’s Hospital.

The disagreement was over rates for a large New York-based doctors group that Children’s Hospital acquired last year. Aetna said Children’s was demanding unacceptably high payments, while Children’s said it wanted to raise the pay of its New York doctors to “reduce the gap” between them and their competitors.

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Hartford-based Aetna insures about 200,000 people in Massachusetts, or about 5 percent of the commercial health insurance market.

“Boston Children’s Hospital is pleased that we’ve reached agreement with Aetna assuring no patient will have care from their preferred caregiver interrupted,” hospital spokesman Rob Graham said.


Priyanka Dayal McCluskey
can be reached at priyanka.mccluskey@globe.com. Follow her on Twitter @priyanka_dayal.