St. Joe's parent company terminating BCBS-TX agreement

3,066 Views | 8 Replies | Last: 3 yr ago by histag10
bushytailed
How long do you want to ignore this user?
AG
https://www.kbtx.com/2020/10/19/commonspirit-health-terminating-services-at-blue-cross-and-blue-shield-of-texas/?fbclid=IwAR0_DRNL3IxwaTU5JAxFLyeET-DJHsMrIOr25ZlD7hb1X0W8yKDszhNsocY
Quote:

BRYAN, Texas (KBTX) - Health insurance provider Blue Cross and Blue Shield of Texas has said that CommonSpirit Health has notified the insurance provider they intend to leave the network on Dec. 16, 2020. This change would affect customers in Brazos, Burleson, Grimes, Madison, and Montgomery counties.
A spokesperson for Blue Cross and Blue Shield of Texas, James Campbell said the insurance company is working towards a mutually beneficial agreement.
"In terminating our contracts, CommonSpirit is not honoring agreements that kept its hospitals in our networks through 2021," a statement from Blue Cross and Blue Shield of Texas said. "Instead, we are forced to renegotiate and divert our attention from the global pandemic at hand."
According to the insurance company, CommonSpirit is proposing rate increases that would drive up the cost of health care in Houston, Bryan-College Station, Lufkin and the rest of the southeast Texas communities they serve.
"We think the demands are unreasonable and will do all we can to represent our members and customers in this negotiation," the statement said. "We want fair contracts that balance the need of our members and providers.
The list of affected facilities is included in the link, but it includes the CHI St. joseph's locations in Bryan and College Station. This will impact any TAMU employee that uses St. Joe's with BCBS.

Hopefully this gets renegotiated before 12/16, otherwise a lot of people are about to see their provider become out-of-network.
EBrazosAg
How long do you want to ignore this user?
AG
It will get fixed. BCBS pays CHI mid single digit less for same thing vs S&W. CHI has known this for years and is just using leverage. It's business.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
histag10
How long do you want to ignore this user?
AG
Does this also mean they would be terminating the brazos valley network they had set up for TAMU employees, or just regular in network bcbs? I thought TAMU got the special rates because of the ties to the med school
dubi
How long do you want to ignore this user?
AG
My husband has rotator cuff surgery scheduled for December 9TH at CHI. I guess we will squeeze in just in time.
EBrazosAg
How long do you want to ignore this user?
AG
Highly unlikely. BCBS is a administrator for TAMU paying their own bills. TAMU could change to Cigna or Aetna any time. And everything else remain the same - except which company makes some set percent to adjudicate claims, etc. The timing of a RFP cycle for the TAMU administration starting in 9/21 is possibly part of the timing of this.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
doubledog
How long do you want to ignore this user?
So the largest health provider in the area will go out-of-network with the largest insurance provider in the area.

Why am I suspicious that this is more about another area's health coverage that is in play.
EBrazosAg
How long do you want to ignore this user?
AG
CHI gave notice in June and entered negotiations. Both sides agreed to not go public with this. BCBS went public now without telling CHI they were to get leverage.... knowing most 1/1 plan dates have started open enrollment or finished already and it's too late for most employers to change. Again - it's all about leverage.
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
KidDoc
How long do you want to ignore this user?
AG
This is a big league fight among the corporate types. BCBS has been short changing St Jo for years and, pre CHI, St Jo just had to put up with it. Now that CHI is multistate they have more bargaining power.

It is a dirty business this big league medical insurance contracting.

I have no inside information this is just from someone who may get squashed in the middle of these two multi-billion dollar businesses.

No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
momlaw
How long do you want to ignore this user?
AG
And this is the price of government intervention in private parties relationships and services.
Government overrides servicing mandates and pricing. Providers have lobbyists. Citizens come in last place.
Health care, schooling, you name it. The promises of free or reduced come with mandates and restrictions.
momlaw
histag10
How long do you want to ignore this user?
AG
Dont get squashed! My kids would be so sad!! You have made such an impact on my son that he asked to be a doctor for halloween. He says his doctor made his tummy better
Refresh
Page 1 of 1
 
×
subscribe Verify your student status
See Subscription Benefits
Trial only available to users who have never subscribed or participated in a previous trial.