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Hello Higher Stakes subscribers! I’m higher education reporter Jane Winik Sartwell, back in your inbox with this week’s news.
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This summer, Duke University is switching providers for its Student Medical Insurance Plan from Blue Cross Blue Shield of North Carolina to Aetna.
The new Aetna plan incentivizes the use of WakeMed, Cone Health, and the university’s own Duke Health system over other in-network medical providers. The Duke, Cone Health, and WakeMed systems are in a special tier dubbed Select Care, which comes with better deals compared to other in-network providers.
Some students are concerned this tiered system will increase costs for in-network providers and complicate access to care. North Carolina’s State Health Plan made a similar switch from Blue Cross to Aetna last year, and recent projections show the state will spend much more than it intended on the contract. Now, the plan has opened a new bidding process that could lead to another switch.
For its Duke contract, Aetna has no deductible at Duke Health, Wake Med, and Cone Health facilities, but charges a $250 deductible at other in-network providers. With Blue Cross Blue Shield of North Carolina, all in-network providers had a $0 deductible.
Copay and coinsurance costs also increase at in-network providers that aren’t in the Select Care tier.
The copay for a visit to urgent care at one of the Select Care systems will cost $45 — what it cost with BCBS — but at other in-network providers, it jumps to $90.
The pattern is similar with other common services. For a regular visit to the doctor, the copay at Select Care systems is $25, while at other in-network providers, it’ll come to $35. For an inpatient surgery, Aetna will pay 80% of the negotiated charge at a Select Care hospital, compared to 70% at other in-network providers.
This setup disadvantages students who see specialists outside of those three providers or work at Duke’s marine biology lab more than two hours away from the Triangle, some graduate students say.
But Rachel Kaufman, president of the graduate student union at Duke, says all graduate students who see in-network providers that aren’t in the Select Care tier have reason to feel cheated. Kaufman sees the tiers as a way to gain more market share over competing providers like UNC Health.
She worries in particular about continuity of care for mental health.
“A lot of us who see specialists in the UNC system would be expected to pay a lot more. Everyone with therapists and psychiatrists have all been set up with Blue Cross Blue Shield, and [it’s possible people will] lose the relationships they’ve developed with their doctors,” she said. “It’s going to flood the system when it’s already completely overwhelmed.”
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Duke announced the switch on their Student Affairs website. It will occur Aug. 1.
“We are very excited to share that we will be partnering with Aetna to serve as our new Student Medical Insurance Plan carrier,” Duke’s website reads. “… Aetna brings a wealth of student insurance experience to this partnership and has more than 40 years of experience serving colleges and universities. They have a robust team of more than 200 professionals dedicated to their student insurance work, which results in resources, tools, and service that is more specific to university students and their distinct needs in an insurance plan.”
Initially, Duke shared a draft plan with students that caused outrage among some graduate student workers. The plan indicated that elective abortions will no longer be covered by insurance, in a more restrictive stance than what state law requires.
Now, Duke promises that coverage will continue.
“An incomplete draft plan shared with students as part of Duke’s notification requirements did not include all of the updated benefits, which caused some confusion,” a statement from a university spokesperson reads.
“Student medical insurance plans are renewed and benefits are updated each year to manage costs while providing outstanding coverage,” the statement continues. “As part of our renewal process this year, Duke is transitioning from Blue Cross Blue Shield to Aetna Student Health for our student medical insurance coverage. Our coverage for most core services — including reproductive health care — will continue as it has in our previous plan, in several cases with improved benefits.”
Duke did not provide further information on how that inconsistency occurred.
Duke says that students with questions about the new plan should address them to the Student Insurance Support Team at [email protected].
A bill making steady progress through the legislature could provide $295 million for NC State to begin redevelopment on Cates West, a 27-acre area in central campus. The university plans to demolish what’s there, including three residence halls, and build more modern facilities with expanded capacity. It will help NC State deal with enrollment growth and the requirement that freshmen must live on campus.
Cates West, when the redevelopment is finished, will be pedestrian-oriented and replete with green space, according to plans. Eventually, there will be 3,000 beds and a 1,100-seat dining space.
When all is said and done in about 10 years, the redevelopment will cost more like $750 million. But if the Senate passes this initial funding for Phase I, it would mean the ball is rolling.
Thanks for reading! See you back here next week.
— Jane Winik Sartwell
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