Duke Health Warns of Potential Split with Aetna

Duke Health, one of the Triangle’s largest and most trusted healthcare providers, has notified patients that it may exit Aetna’s insurance network if a new agreement isn’t reached by Monday, Oct. 20. The move could affect thousands of South Durham residents who rely on Duke physicians and facilities – from urgent care at Southpoint to specialty and hospital services throughout the region.

In a letter sent this week to patients across North Carolina, Duke Health said it is currently in contract negotiations with Aetna over reimbursement rates. If the two parties fail to reach a deal, Duke Health will become out-of-network for all Aetna commercial and Medicare Advantage plans starting Oct. 21, potentially raising out-of-pocket costs for patients or forcing them to seek care elsewhere.

“Without fair reimbursement that covers the rising cost of care, we cannot maintain access to the services patients depend on,” wrote Dr. Thomas A. Owens, Duke’s executive vice president and chief operating officer, in the joint letter signed with CFO Lisa M. Goodlett.

What This Means for South Durham Patients

For now, patients can continue seeing Duke providers as usual. But the looming deadline leaves many local Aetna members facing uncertainty.

Should negotiations fail:

Patients may have to pay more for visits and procedures at Duke locations.
Many will be forced to switch doctors or hospitals, including for ongoing care.
Access to popular Duke Health services near Southpoint, Fayetteville Road, and other South Durham sites could be restricted.

This is not the first time a major health system has clashed with an insurer over contract terms, but the scope of this dispute is significant. Duke Health is North Carolina’s top-ranked hospital system and a major provider of primary care, pediatric services, and specialty care throughout Durham County.

What Patients Can Do

Duke is urging patients with Aetna to take action:

Call Aetna (using the number on the back of your card) and ask them to keep Duke Health in-network.
Talk to your employer about preserving in-network access, especially if your insurance is job-provided.
Medicare Advantage patients are encouraged to speak with their insurance brokers.

Duke has launched a website, DukeHealthAccessAetna.org, to provide updates on the negotiations and what’s at stake.

What’s Next

With nearly three months until the contract expires, there is still time for the two sides to reach an agreement. But the early public outreach suggests Duke is preparing patients for a possible disruption. In South Durham – where Duke-affiliated practices are a cornerstone of community healthcare – residents are watching closely.

For now, both sides remain at the table. But for patients, especially those with chronic conditions or upcoming procedures, the clock is ticking.