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Mount Carmel going along with program, but Grant/Riverside balking
Grant/Riverside Methodist Hospitals is saying "no" to an on-site care-review program Aetna U.S. Healthcare wants to start in Columbus, while Mount Carmel says it will work with one of the area's largest managed-care companies.
Aetna wants to send nurses into hospitals, where they would review patient charts in what the insurer says is an effort to improve care but reduce costs.
"We wanted to start at Grant/Riverside in April, but it keeps getting delayed," said Dr. Climenteme Jones, senior regional patient management medical director at Aetna's Chicago office. "We'll continue talking with them until we get it resolved."
But that may not be anytime soon. Grant/Riverside isn't interested in seeing Aetna nurses walk through its doors.
"They have not yet demonstrated that there is a reason to do on-site reviews, and until they do we are not going to do it," said Charles S. Koch, senior vice president of managed care at OhioHealth, the...