Blue Cross Blue Shield says Baylor Scott & White could move out of network
The state's largest insurer and the state's nonprofit health care system are at odds. Blue Cross Blue Shield of Texas has warned its members that Baylor Scott & White Health could move out of network, causing uncertainty for thousands of patients. The state's largest insurance provider, Blue Cross Blue Blue Shield, has informed members that the nonprofit health care system could be removed from its network if it doesn't significantly increase its payments to the system. If the two parties cannot reach an agreement, Baylor's doctors, hospitals, and facilities will no longer be covered as in-network. Blue Cross will work with members to switch doctors if necessary. This comes amidst a health care affordability crisis in Texas, where nearly 5 million people lack health insurance, the highest rate in the nation.
Publicerad : 10 månader sedan förbi Naheed Rajwani-Dharsi i Health
Blue Cross Blue Shield of Texas is warning patients that Baylor Scott & White Health could move out of network. Why it matters: The state's largest insurance provider recently sent letters to its members notifying them that the state's nonprofit health care system could be removed from its network, causing uncertainty for thousands of patients.
State of play: Baylor Scott & White has told Blue Cross Blue Shield it will terminate their relationship July 1 if the insurer doesn't significantly increase its payments to the system, a Blue Cross spokesperson tells Axios.
• They're still negotiating. If they can't reach an agreement, then Baylor doctors, hospitals and facilities will no longer be covered as in-network.
• This site lists plans that would be affected. Blue Cross Blue Shield says it will work with members to switch doctors if needed.
The big picture: Texas is facing a health care affordability crisis, per the nonpartisan policy group Texas 2036.
• Premiums are high and health care markets aren't healthy, making it harder for people to access affordable care, Texas 2036 said.
• Seventeen percent of Texans — nearly 5 million people — lack health insurance, the highest rate in the nation.
What they're saying: "Our goal is to reach an agreement that would protect our members' and customers' access to quality care at fair rates," Blue Cross Blue Shield said in a statement.
• "Our patients are our priority, and we're continuing to negotiate in good faith to prevent any disruption," Baylor Scott & White said in its own statement.
Meanwhile: If the two terminate their in-network partnership, members who are pregnant or have a disability, acute condition or life-threatening illness may qualify for continuity of care coverage that will allow them to receive Baylor care at in-network rates.
Zoom out: The U.S. has some of the highest health care costs in the world, and they keep rising.
• Americans spent $4.4 trillion on care in 2022 — 30% of it on hospital visits and 15% on doctor visits.
• The costs have led many Texans to skip medical treatment or surgery over uncertainty about the final cost.
What we're watching: Whether Baylor and Blue Cross Blue Shield will come to an agreement so patients won't have to switch doctors.