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Health Network Providers Reach New Deal

Health

Southwestern Medical District Sign | Image by WFAA

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Southwestern Health Resources (SWHR) and Blue Cross Blue Shield of Texas (BCBSTX) announced a new multi-year agreement in a joint statement issued on October 4, following the September 20 announcement that the two would no longer operate together.

“This agreement provides BCBSTX members continued access to Southwestern Health Resources’ network providers, which includes UT Southwestern and Texas Health Resources doctors and facilities,” their statement said.

Texas Health, one of the largest hospital systems in North Texas, is part of Southwestern Health Resources, a comprehensive health network of 29 hospitals in North Texas, including Presbyterian in Dallas, Arlington Memorial in Arlington, Harris in Fort Worth, and UT Southwestern Medical Center, reported The Dallas Express.

If the contract had not been renewed, UT Southwestern and Texas Health doctors would have been forced to leave several BCBSTX networks. These include the Par Plan, Blue Essentials, Blue Choice PPO, Medicaid, and Medicare Advantage, ABC News reported.

The three healthcare providers said in a September 20 statement that they were “Committed to reaching an agreement as soon as possible” since Blue Cross in-network coverage would be terminated if an agreement was not reached by October 4.

In other words, without an agreement, some patients would not have been eligible for continuity of care benefits, according to the providers.

The hospital systems have negotiated with Blue Cross since July 2021, according to Southwestern Health Resources officials.

As in previous disputes between SWHR and BCBSTX in 2016 and 2018, the agreement was reached on the contract’s expiration date. The terms of the multi-year contract are being kept private, according to ABC News.

SWHR requested a $900 million increase in reimbursement over the next 32 months, which Blue Cross claimed was out of line with what other health systems had requested in recent contracts, according to an email sent to brokers last week.

The Dallas-Fort Worth region is already one of the country’s most expensive large metropolitan areas for health care, with some of the country’s highest medical debt.

Many of the region’s health systems, including Texas Health Resources and Children’s Health — both of which employ UTSW physicians — are more profitable than the region’s Fortune 500 average, D Magazine reported.

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