On Tuesday, the state treasurer warned that he is preparing for what happens if Duke and Aetna can't agree on a deal. Only about 3 percent of the 700,000 state employees use Duke Health. "I want to first be clear that this is a negotiation between Duke Health, a not-for-profit health system, and Aetna, a for-profit health plan," Owens said. Even with those difficulties, Duke Health, a non-profit hospital, made $600 million last year. Duke Health and Aetna have a deadline of Oct. 20 to come to an agreement.