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Duke Health and Aetna have concluded a heated rate negotiation with just weeks to spare before the health care giants’ contract expired.
The contract determines reimbursement rates that insurer Aetna will pay Duke Health, which operates a sprawling health care system anchored by the largest hospital in the state. Aetna is the third-party insurance administrator for the state’s public employees, which includes retirees, teachers, and their dependents. With 743,000 members, the State Health Plan makes up the bulk of Aetna’s business in North Carolina.
As negotiations stalled this summer, Duke Health kicked off a contentious campaign, urging its patients through a website, letters, and radio ads to contact Aetna to keep their providers in-network. Duke had requested higher rates to accommodate rising medical costs and had not received a rate adjustment from Aetna in four years. Meanwhile, Aetna wanted to keep any increase as modest as possible to keep member premiums in check.
State Treasurer Brad Briner, who oversees the State Health Plan, took an aggressive tack against Duke last month, accusing the nonprofit health system of being greedy and “tone deaf.” Meanwhile, Duke officials downplayed Briner’s role in the negotiations and insisted the requested rate increases were necessary and reasonable.
At the start of the year, the State Health Plan was facing a half-billion-dollar deficit; Briner’s office implemented interventions, and now expects to break even in 2026. In a release Friday, Briner said he appreciated the steps Duke took to keep costs down.
“We have worked hard to dig ourselves out of a massive deficit and needed the help from all providers in the state to get that done,” Briner said. “This deal represents Duke’s commitment to serve North Carolina and our members.”
Last week, the State Health Plan Board of Trustees took the unprecedented step of preparing a contingency plan for members to prepare for losing Duke Health as an in-network provider. At the meeting, Briner said the health system’s negotiating tactics were “beneath Duke.”
A spokesperson for CVS Health, Aetna’s parent company, said it had nothing to add beyond Duke’s release. Thomas Owens, executive vice president and chief operating officer of Duke University Health System, said the agreement helps drive down health care costs.
“Throughout this negotiation, we have remained committed to our nonprofit mission of serving the best interests of our patients and community,” Owens said in a statement.
A spokesperson for Briner said details of the agreement are not being released and will not affect the next round of decisions regarding 2027 rates.
