Healthcare insurance provider Blue Cross and Blue Shield of Texas and the hospital system Texas Health Resources are reaching the end of their current deal for in-network services without an agreed-upon replacement in place.
The current contract expires October 4, and both sides are continuing to negotiate a potential deal.
In a statement released Tuesday, Blue Cross officials said they received notice from Southwestern Health Resources stating it would be leaving Blue Cross networks after negotiations reportedly failed to progress.
Southwestern Health Resources, a comprehensive health network, includes Texas Health, one of the largest hospital systems in North Texas. UT Southwestern Medical Center is also a part of Southwest Health Resources.
“We continue to negotiate and remain committed to reaching an agreement as soon as possible,” read a joint statement by the three healthcare providers.
The providers stated that if an agreement is not reached by October 4, in-network coverage by Blue Cross will end. However, some patients could qualify for continuity of benefits.
Patients going through specific courses of treatment or who are in their second or third trimester of pregnancy are encouraged to apply for continuity of care, according to the providers. Successful applications would result in continued in-network healthcare coverage.
According to Southwestern Health Resources officials, the hospital systems have been negotiating with Blue Cross since July 2021.
For their part, Blue Cross officials claimed Southwestern Health Resources is “demanding a significant increase” in rates over the next 32 months. However, they did not disclose precisely how much the hike would be.
“SWHR’s rate demand is clearly not in the best interest of our members, Dallas Fort-Worth businesses or the communities we serve,” said Shara McClure, Blue Cross and Blue Shield’s senior vice president for Texas healthcare delivery.
“As a customer-owned health insurance industry leader in Texas for more than 90 years, it is important to stand up for affordable care, especially in a time when most businesses and our members are facing inflationary pressures and a potential recession.”
Such impasses between Texas Heath and Blue Cross have not been all that uncommon. A dispute in 2018 halted negotiations on a previous contract, with Blue Cross asserting that the health network was requesting $1 billion in increased payments through the duration of the proposed four-year contract.
Texas Health Resources, for its part, stated back then that Blue Cross’ “inaccurate and misleading claims [were] polarizing and distracting” from working to hammer out a new deal.
Another impasse in 2016 lasted to within a few days of contract expiration.
Both in 2016 and 2018, a lapse in coverage was avoided because the parties reached a deal.
Texas Health Resources operates 29 hospitals across North Texas, including Presbyterian in Dallas, Arlington Memorial, and Harris in Fort Worth. It is also one of the largest faith-based, non-profit health systems in the United States and the largest in North Texas based on the more than 7 million patients it serves throughout the region.
