An important Texas health network and a major Texas insurance company continue to fight for a new contract. Failure to reach a deal by the end of the month could mean fewer options in the network for thousands of central Texans.
The fighters are Texas climbparent of Ascent Providence in wacoand Texas Blue Cross and Blue Shield. Patients at risk are covered by blue cross and want or need treatment at an Ascension-branded hospital or surgery center in the state, including waco.
Texas climb said in a statement that it continues to negotiate contractual terms “that will ensure that BCBSTX policyholders maintain access to the network at Texas climb hospitals, doctors and hospital clinics, including Dell Children’s Medical Centerand some joint venture facilities, including day surgery centers. »
The statement states that “without commitment on reasonable terms”, Ascension’s agreement with blue cross will end January 31 for commercial and Medicare Advantage members.
Texas climb urges patients to contact Texas Blue Cross and Blue Shield for more details on how their coverage might be affected, asking them to use the number on the back of their insurance card “to raise concerns”.
Blue Cross and Blue Shieldmeanwhile, says he is working to reach a deal that will control costs.
“We appreciate the care Ascension provides to our members, but it’s already one of the costliest healthcare systems in the world. Austin and Central Texas region”, a Texas Blue Cross and Blue Shield says the statement. “As an industry leader in customer-owned health insurance in Texas For more than 90 years, advocating for affordable care has been important, especially at a time when most businesses and our members of the Austin and Central Texas face inflationary pressures and a potential recession. »
Without an agreement, Ascension physicians would be removed from the Blue Choice PPO, Blue Essentials, and Medicare Advantage networks on 1st Mayand physicians and healthcare professionals would leave the Blue Advantage HMO network on June 15according to the press release.
Texas Blue Cross and Blue Shield challenges Ascension on its rapid expansion in Texas during the last years. It specifically mentions the Ascension Seton Health System serving Austinsaying, “He bought several specialist groups and outpatient surgery centers, immediately increasing the costs for the patients of those acquired doctors and facilities.”
“Studies show that health care consolidation leads to higher prices and does not necessarily lead to better quality care for our members,” the statement said.
It says blue cross “is prepared to pay fair rates, but our members should not expect to fill Ascension gaps in other states.” He notes that Ascension is headquartered in Saint Louis and has more than 2,600 care sites, including 139 hospitals in 19 states.
Texas Blue Cross and Blue Shieldmeanwhile, bills itself as the state’s largest health benefits provider, “working with nearly 80,000 physicians and health care practitioners and 500 hospitals to serve 6 million members in all 254 counties.”
Austin American Statesman reported 66,000 people with Texas Blue Cross and Blue Shield insurance have used the services of the Ascension Hospital or Clinic in the past year.
blue cross said that if an agreement is not reached, he will do everything possible “to help members transition their care to quality, cost-effective, network-integrated hospitals and healthcare professionals.”
His statement says that any hospital’s emergency or trauma services, regardless of existing contract, are covered at network rates for blue cross members.
