Dr. John Tedeschi, who has a private practice in Robbinsville, N.J., says Aetna dropped him without citing a reason, and the health insurer confirmed that it is within its contractual right to do so.
“Aetna never once found a thing wrong with my charts,” Tedeschi, 59, told The Courant.
The video is the latest sign of friction between health care providers and insurers, as the pressure of cost-controls mounts. Tedeschi, in the video, implores physicians to defy insurance companies, and “stand up and practice this noble profession.”
He hired a broadcasting professional to shoot the video and to act as a public relations firm, which sent media releases to news outlets in the Northeast and elsewhere.
“As a physician, I have been questioned by Aetna continuously to be part of their physicians for their managed care for the elderly,” Tedeschi says in the video. “They have called my office greater than 20 times, continuously asking me to participate. I told them that I do not wish to participate in a managed care program for elderly people.”
Elderly people need more time than younger patients and managed care will eliminate “a considerable amount of care, and it’s going to eliminate appropriateness of evaluation, appropriateness of diagnoses and evaluation,” he said.
After declining to get involved in the program, Tedeschi says he received a letter saying he will no longer be an in-network provider for Aetna as of June 12.
Aetna spokeswoman Susan Millerick said that Aetna, as part of its standard business practice, periodically reviews its local market provider networks “to ensure the network adequately meets competitive market demands and the needs of our current members and customers.”
“We recently conducted an intensified evaluation of our networks for network adequacy and cost competitiveness,” Millerick said.
As a result of this review, Aetna exercised its right to end its relationship with a limited number of providers, Millerick said.
“Our contracts with these providers do not require us to show cause for termination,” she said. “Therefore, we have no cause to share. We took this difficult step in response to customer demands for smaller networks that are less expensive to maintain and can lead to lower health care costs.”
The network cuts affected 4 clinicians in Connecticut, 25 in New Jersey and 552 across the U.S., which is about 0.1 percent of Aetna’s network.
“During the last five years Aetna has grown its provider networks on average of 25,000 providers per year,” Millerick said. “The market dynamics have recently changed. Customers are demanding more cost-competitive health plans and are willing to accept smaller networks to achieve these goals.”
The Connecticut State Medical Society hasn’t heard of an instance of a Connecticut doctor taking rustrations about health insurers to YouTube. But the society has received angry e-mails and phone calls from doctors overwhelmed by health insurers’ tactics, said Matthew Katz, executive vice president and CEO of the medical society.
“There is definitely a fear by the physicians of retribution if they speak out against insurers,” Katz said.
Tedeschi, in the video, says he tried contacting Bertolini, but was told Bertolini doesn’t speak to doctors.
“I think it’s amazing that as a physician, trying to save lives and help individuals, is controlled by an individual that made $8 million last year,” Tedeschi says, as he sits behind his desk. “And he’s not a physician. He’s directing health care. He’s some great entrepreneur that’s going to change the world in technology and he doesn’t have time to talk to physicians.”
Bertolini’s 2011 salary has not yet been disclosed publicly. In 2010, Bertolini was compensated $4.8 million in salary, incentive pay , change in pension value, stocks vested and other compensation. Additionally, he received $5.8 million in stock awards that vest later and depend on performance. Outgoing CEO Ronald A. Williams received $72 million in total compensation that year — including $14.3 million in stocks that vest later and depend on the company’s performance.
“So far, the insurance companies, the CEOs, are strictly based on monetary wisdom, and that will never satisfy our human need,” Tedeschi says in the video. To fellow doctors, he adds, “Don’t practice what somebody tells you to practice...Practice what you believe in your heart of hearts...Practice it like it’s your last day on Earth.”