A Local Lawmaker and the Bipartisan Fight Against Balance Billing

Inside the halls of government, special interests often trample on the will of the people, and the Texas Legislature is no different. But over the course of nearly a decade, a local lawmaker has resisted push-back from physician groups and insurance companies to fight surprise medical bills, or balance billing to the tune of $21 million, and he hopes to continue battling in the upcoming legislative session. State Senator Kelly Hancock (R-North Richland Hills) became aware of the problem when some of the employees at his church began describing an issue that was all too familiar to many who have… Full Story

Business Group and Providers Find Millions in Back Pain Savings

An employer group teamed up with local providers to codify treatment for lower back pain that they say could save local employers millions. The course of care for patients was evidence-based and is meant to improve efficiency and bring down costs. The Dallas-Fort Worth Business Group on Health created the Innovative Quality Healthcare Collaborative with the help of providers that include Baylor Scott and White Health Texas Provider Network, Catalyst Health Network, Spine Team Texas, and Texas Back Institute to create courses of care for employers to bring down healthcare costs. The course was created after researching what is normally done… Full Story

Local Judge Rules Affordable Healthcare Act Unconstitutional

Judge Reed O’Connor sided with 18 Republican attorneys general and two governors who argued that without the tax mandate, the Affordable Care Act was unconstitutional. O’Connor presides in the United States District Court for the Northern District of Texas, which is based in Dallas. The federal court ruling said that the latest tax bill, which eliminated the tax penalty in the ACA for not buying insurance, made the law unconstitutional. The ruling was in conflict with an earlier Supreme Court ruling that validated the law based on the fact that the penalty was a tax, which the federal government can do.… Full Story

Blue Cross President: Drug Prices Have “Lost All Relationship to Any Sort of Sanity”

A Healthcare Cost Institute report named Dallas as one of the most expensive places in the country to get healthcare. At the Dallas-Fort Worth Business Group on Health’s Forum this month, Dr. Paul Hain put the blame at the feet of local consolidation and increased drug prices. The HCCI report is a visually pleasing infographic where one can see how their city’s healthcare costs compare to other metro areas around the country. Called the Healthy Marketplace Index, it names Dallas as the 17th most expensive city in the country in 2016. Overall, DFW’s healthcare costs are five percent above the… Full Story

Rural Hospitals Say They Are Being Strong-Armed By Blue Cross Blue Shield of Texas

Several rural hospitals say that Blue Cross Blue Shield of Texas is using its influence to negotiate unfavorable contracts that slashed reimbursement rates from the insurance company, according to the Texas Observer. The piece features Iraan General Hospital in West Texas, who was already losing over a million dollars a year before new CEO Keith Butler took over and received a new contract from Blue Cross, whose reimbursement provides most of the hospital’s revenue. “I pulled it up and started looking at the contract,” Butler told the Observer. “It was terrible. It would have hurt this hospital a lot.” Butler sent back… Full Story

PepsiCo Hopes to Change the Way Its Employees Use Healthcare By Paying For It

PepsiCo chose North Texas as the first region where it will pay employees’ insurance premiums if they use certain physician groups, a savings of up to $650, according to the Dallas Morning News. Over 5,200 employees and their families enrolled in the program, whose goal is to get more people to see their primary care physician. If workers from Pepsi see a physician before April, they get a $100 gift card, DMN reports. They can choose between Catalyst Health Network, Genesis Physicians Group, and the North Texas Clinically Integrated Network as their primary care doctors. Pepsi chose DFW because its workers’ healthcare costs are $3,000… Full Story

Collaboration is Key to Improving Health Insurance Coverage

In 1965, President Lyndon B. Johnson signed the the Medicaid program into law as a part of Title XIX of the Social Security Act Amendments. Today, Medicaid covers one in five low-income Americans, as the majority of enrollees lack access to affordable health insurance. Each state administers the Medicaid program and must comply with federal standards. Amongst the successes and failures of the landmark legislation, misunderstandings persist. States have flexibility in determining covered populations, covered services, delivery models and reimbursement. They are also guaranteed federal matching dollars for services to beneficiaries, so the Medicaid program is financed jointly by federal… Full Story

UT System Employees Have a New Medical Plan Via Southwestern Health Resources

Employees and retirees of the University of Texas System in North Texas will now have access to a new medical plan through Southwestern Health Resources, the accountable care organization formed by UT Southwestern and Texas Health Resources. More than 4,000 people have enrolled in the medical benefit option, named UT CONNECT, since it opened September. This is the first time the UT system has offered a program based on the ACO model of care, where providers collaborate and have payments tied to quality of care rather than fee for service. The UT system in the area, which include UT Arlington, UT… Full Story

The Election is (Mostly) Decided – How It Impacts Healthcare in North Texas

It’s been a week since the election, and many may be wondering how the results will change the healthcare industry, if at all. Clearly top of mind for many, a Deloitte study said that 26 percent of voters said healthcare was their top issue and three out of four voters who responded that way voted for Democrats. We touched base with John McCracken, clinical professor of healthcare management at The University of Texas at Dallas Jindal School of Management and adjunct professor of family and community medicine at UT Southwestern Medical Center and Thaddeus Miller, associate professor in the University of… Full Story

Payment Reform – Can It Impact Healthcare Costs?

Last month, we began to recap the panel discussion at UT Dallas’s Center for Healthcare Management and Leadership, discussing our country’s healthcare spending and how much we get out of it (spoiler, we don’t fare well). We thought we would continue to recap to share the better (not sure if it is quite good) news. The U.S. government’s largest expenditure is healthcare at 28 percent, and it is 30 percent in Texas. That is more than Social Security, national defense or welfare. But it wasn’t all bad news. The panel also discussed how payment reform could slow the growth and maybe… Full Story