Dallas Has the Worst Uninsured Rate in the Nation

Nearly a quarter of Dallas residents are uninsured, according to a study that measures uninsured rates across the country. The WalletHub study ranked Dallas as the large city (over 300,000 population) with the highest rate of uninsured residents. It was ranked 539 out of 548 of all cities included in the study, which analyzed Census Bureau data. North Texas neighbor Garland was the seventh worse overall. Out of the 10 least insured cities in the country, seven were from Texas. Texas has long held the dubious distinction of being the state with the highest uninsured rate in the nation. The… Full Story

Now Open: Blue Cross Blue Shield’s First North Texas Clinic

The first of Blue Cross Blue Shield of Texas’ medical centers is now open in Richardson as the insurer moves into the provider space with 10 new facilities statewide in  a partnership with Sanitas Medical Center. The clinics provide holistic primary care in partnership with Sanitas USA, a branch of the Spain-based provider that has several clinics in Florida, New Jersey, and Connecticut. The new clinic is part of a larger consolidation movement across the region and nation in the healthcare industry. Providers have developed their own partnerships with insurers, employers directly contract with providers, and insurers become providers, all… Full Story

Texas’ Dismal Health Insurance Rate: Causes and Economic Impact

Texas has the worst rate uninsured people in the country for the second year in a row, according to information released by the U.S. Census Bureau. Texas was one of only nine states to see an increase in the number of people without health insurance, as the rate increased from 17.3 percent in 2017 to 17.7 percent (around five million people) in 2018. The increase could see increased stress put on the healthcare system in North Texas and statewide, having significant economic impacts. Texas has nearly twice the rate of uninsured people as the country, with had an 8.9 percent… Full Story

Walmart’s Local Pilot of a Physician Network Based on Quality

Walmart has launched a pilot benefits program that selects physicians based on quality, the Dallas Morning News reports. The Walmart network will be built from physicians accepting new patients who meet quality standards in primary care, cardiology, gastroenterology, endocrinology, obstetrics, oncology, orthopedics and pulmonology. The network by Walmart is one of many moves across the country to shift healthcare spending to physicians who avoid unnecessary surgeries, follow evidence-based care pathways, and cut overall spending and waste, which is especially prevalent in musculoskeletal procedures, which are also some of the most expensive. City governments and private companies alike are incentivizing their employees… Full Story

Only Half of Employer and ACA-Insured People Can Afford Their Emergency Care

In the case of emergencies, only half of respondents with employer-provided plans (46.7 percent) and respondents with ACA plans (47.8 percent) were able to afford emergency medical bills, according to a study by health insurance marketplace, HealthMarkets. The company’s survey analyzed healthcare costs under varying medical circumstances for insured and uninsured families. The survey highlighted healthcare costs under three cost conditions – monthly out-of-pocket costs, emergency medical costs, and costs related to pre-existing conditions. Almost 40 percent of respondents with employer-provided plans needed six months or more to pay off emergency costs, and 14.2 percent could not afford any costs associated… Full Story

Direct Contracts Are Growing Because “PPOs Don’t Work Anymore”

Direct contracting is quickly growing in the insurance world because “PPOs don’t work anymore,” according to Bud Brooks, Vice President of Sano Surgery. Brooks spoke at a Free Market Medical Association luncheon in Dallas earlier this month and has 25 years in the healthcare and benefits space. PPOs artificially inflate the cost of medical care, Brooks says, because the carriers who build the networks need to take a cut for themselves. Direct contracting offers a level playing field for payors and providers, where neither are dependent upon discounts on inflated prices, or threats to cut people out. If the price… Full Story

Texas Has Third-Highest Insurance Rebates For Individual Market

Private insurers will pay a record of around $1.3 billion in rebates to consumers this year for excessive premiums relative to health care expenses, surpassing the record high of $1.1 billion in 2012, according to a Kaiser Family Foundation report. Rebates may either be paid out in the form of a premium credit or as a lump sum, though lump sum is more common. Rebates are the result of insurance companies not meeting the Affordable Care Act’s medical loss ratio threshold, which requires insurers to spend at least 80 percent of premium revenues (85% for large group plans) on health… Full Story

Blue Cross-Knox City Conflict May Be Going to Federal Court

Blue Cross Blue Shield of Texas is hoping to move the legal battle with Knox County Hospital District to federal court, and the temporary restraining order hearing scheduled for September 10 has been suspended. After 50th District Court Judge Bobby Burnett issued the TRO ordering BCBS to pay Knox County Hospital more than $21 million in what they allege are unpaid insurance claims, BCBS filed a motion in U.S. District Court for Northern Texas in Wichita Falls to move the case to federal court because BCBS of Texas is owned by Health Care Services Corporation in Chicago. “Blue Cross Blue… Full Story

How Award-Winning Dean Foods Flipped Its Healthcare Spend

One might not expect a dairy company to be a top innovator when it comes to providing healthcare to its employees, but Dallas’ Dean Foods has an award winning benefits plan that is keeping quality high while flipping eight percent annual increases to outright annual reductions. Dean Foods began attracting attention when it won the Texas Star Award from the Texas Business Group on Health and Health Value Award from the Validation Institute, both for healthcare innovation. Behind milk and payroll, healthcare is one of the top spends for Dean Foods and its 15,500 employees, and several years ago they… Full Story

Direct Primary Care Now Offered Through Baylor Scott and White ACO

Baylor Scott and White Health is joining the direct primary care movement with a new model in several North Texas clinics this year. The model will allow employers to customize the provider network and make a regular contribution to membership fees, making pricing transparent to control costs and avoid hospitalizations. As in other DPC relationships, members are charged a monthly fee that covers office visits and lab tests. Insurance is still needed for hospitalizations and other services, but because primary care needs are taken care of, patients might be more likely to choose high deductible plans with low premiums. The… Full Story