Via Christi Health has opted out of the Wichita school district’s health insurance network, a move that is expected to send more than 1,000 teachers and other employees scrambling to find new primary care doctors.
“It is causing some panic,” said Shannon Krysl, head of human resources for the Wichita district. “There’s a lot of change going on and it’s kind of like a tsunami, where it’s all happening at once.”
Krysl said the school district — among the Wichita area’s largest employers, with about 5,800 people on its health plan — learned from Via Christi earlier this month that beginning Jan. 1, its family practice doctors and other providers would no longer be in the USD 259 network administered through Aetna.
“This was a Via Christi decision, not a USD 259 decision,” Krysl said.
The reason: The district’s plan limits patients to Wesley Medical Center for inpatient hospital care if they want lower, negotiated rates.
It is causing some panic. There’s a lot of change going on and it’s kind of like a tsunami, where it’s all happening at once.
Shannon Krysl, head of human resources for the Wichita school district
Dave Gambino, chief strategy officer for Via Christi, said the company opted out of the plan because it’s harder for doctors to quickly access information about patients when they receive services outside the Via Christi network.
“We just no longer feel that it’s a model that we can participate in because it goes against our model of clinically integrated care that we are building,” Gambino said.
“It fragments care and fragments information, and that makes it more difficult for our practices to fully manage the care of patients.”
Gambino said Via Christi notified Aetna in June that it planned to pull out of the narrow-network plan the school district uses for its employees.
It’s unclear how many employees will be affected by the change, but Krysl estimated it likely would be more than 1,000.
Via Christi officials have met with Krysl and Wichita superintendent John Allison to try to ease the transition and “minimize the disruption for patients and their physicians,” Gambino said.
Beginning Jan. 1, the school district’s health plan will require members and their dependents to designate an in-network primary care physician in order to enroll and receive the in-network level of benefits. If they don’t select a physician during enrollment next month, Aetna will assign one to them.
Krysl said there is not a list of network-approved primary care doctors yet, but one should be finalized in time for a series of employee health plan information meetings scheduled for next month.
The meetings are: 7 a.m. Nov. 1 at the School Service Center training room, 37th Street North and Hydraulic; 6 p.m. Nov. 1 at the Joyce Focht Instructional Support Center, 412 S. Main; 6 p.m. Nov. 2 at the School Service Center; and 6 a.m. and 2 p.m. Nov. 3 at the School Service Center.
“We’re still working through this,” Krysl said. “If people will come to those (meetings), they can hear exactly how it’s going to work, and I think that will calm a lot of people down.”
As soon as possible after enrollment, Krysl said, employees adding or changing a primary care doctor should schedule a “get acquainted” meeting with the new doctor.
If an employee has a health issue prior to establishing contact with the new doctor, Via Christi and Aetna have agreed to allow the person to see the former, Via Christi-affiliated doctor at the in-network rate, Krysl said. That arrangement will continue through March 31, she said.
She said the district is working to contract with some Via Christi specialists to remain in network, but those arrangements have not been finalized.
Gambino, the Via Christi official, said his company is continuing to talk with Aetna and the district in hopes of finding a way to continue serving patients.
“As painful as this is … we believe and are committed to our model (of care), and this really creates challenges for us,” he said.
“We just really need to get to a point where all products that we participate in would allow our Via Christi physicians to use our Via Christi facilities.”
A tentative contract approved by Wichita teachers Friday includes a base health insurance plan with no premium and two “buy up” plans with monthly premiums but lower deductibles and out-of-pocket maximums.