How Trump’s Transparency Executive Order Will Impact North Texas Healthcare

Last week, President Trump signed an executive order meant to improve price transparency in healthcare. As the market moves toward increased transparency, local healthcare companies are trying to figure out how it will impact their business, and some are very well-positioned to embrace the move toward a purer market. “Opaque pricing structures may benefit powerful special interest groups, such as large hospital systems and insurance companies, but they generally leave patients and taxpayers worse off than would a more transparent system,” the order reads. In January, a federal law went into place forcing hospitals to post their prices, though these… Full Story

Does Price Transparency Help You Shop Around?

As of January 1, 2019, all hospitals in Texas have to publish what they charge for all tests, imaging, surgeries, or other procedures. Though many welcome the move toward price transparency, the lists of charges can be difficult to interpret, and, when insurance is factored in, the out-of-pocket costs might look nothing like the posted charge. We spoke with Paul Hain, chief medical officer and divisional senior vice president of market delivery at Blue Cross Blue Shield of Texas, about the impact of the new law.  Comparison shopping is key, right? Price transparency is important because it allows people to understand… Full Story

Blue Cross Blue Shield President Dan McCoy’s Photography Passion

Hacking through the jungle on a remote Indonesian island, Dr. Dan McCoy found himself in the middle of a curious mix of indigenous and modern culture. The villagers lived without electricity and running water, but often wore t-shirts with brands and images they may have known nothing about. He was a long way from the buttoned-up offices where he serves as President of Blue Cross Blue Shield of Texas, but that is exactly where he wanted to be. McCoy’s passion for street photography is one that he developed after years of work in the dark room, transitioning from a self-described… Full Story

The ER Doc-Blue Cross Blue Shield Conflict is More Complicated Than It Seems

Emergency Department physicians being out of network is nothing new, but a new round of failed negotiations between a local emergency physician group and Blue Cross Blue Shield of Texas have both sides crying foul and pointing fingers. Blue Cross Blue Shield contacted members to describe how Texas Medicine Resources, a physician group hired by Texas Health Resources emergency rooms, has terminated its deal with BCBSTX, meaning the group is now out of network at 14 area hospitals for its Blue Choice PPO and Blue Essentials HMO members. A statement on BCBSTX’s “Stand With Texas” website calls the demands of the ER doctors “unreasonable,”… Full Story

Battling the Sickest ZIP Code in Dallas

A study performed by the Dallas-Fort Worth Hospital Council found that 75216 in southern Dallas is the unhealthiest ZIP code in the city. In an effort to address social factors that determine a majority of health outcomes in any community, the council looked a number of chronic diseases such as asthma, obesity, heart disease and depression, and found that area has the highest rate of nearly every disease that was measured. The analysis was done in order to help organizations such as the American Heart Association target certain areas with their health outreach, which was discussed during Dallas Startup Week… Full Story

The Potential Impact of Blue Cross Blue Shield’s Medical Centers

Last week, Blue Cross Blue Shield of Texas announced its entry into the provider space with 10 clinics opening near Dallas and Houston next year. The clinics will include primary care, urgent care, lab and diagnostic imaging services, care coordination, and wellness and disease management programs, and were framed as part of the insurer’s desire to advance value-based care in the medical space – but other providers see the clinics as direct competition. Value-based care is growing in popularity as the industry transitions away from fee-for service, where providers are paid based on the number of procedures or tests that… Full Story

Autonomous Vehicles and Drones May Help Address Rural Healthcare Disparities

Autonomous vehicles, drones, and tele-enabled ambulance services are being considered to address rural health disparities by a partnership between Blue Cross and Blue Shield of Texas and Texas A&M Health Science Center. The joint project will research innovative care delivery strategies and other rural health issues. BCBS of Texas is contributing $10 million to the Health Science Center as a part of the Affordability Cures program to reduce healthcare costs, address health disparities and improve social determinants of health. Projects will look at engaging vulnerabilities and improving access to healthcare, which will include the use of autonomous vehicles, drones, and… Full Story

How Concentrated is the Texas Health Insurance Market?

According to data from the Government Accountability Office, the three largest private insurers held at least 80 percent of the large group health insurance market in 43 states. Overall, the three largest private health insurers held 80 percent of the employer market in 2015-2016, as first reported in Becker’s Health Review. Compiled from data submitted to the Centers of Medicare and Medicaid, the report reveals that Blue Cross Blue Shield parent company Health Care Services Corporation held 45.2 percent of the overall large group health insurance market in 2016, down from 49.2 percent in 2014. Texas’ three largest private insurers had… Full Story

Lawsuit Forces Blue Cross Blue Shield of Texas to Pay $75,000 to Deaf Applicant

A federal judge signed a decree requiring Richardson-based Blue Cross Blue Shield of Texas to pay a deaf woman $75,000 and other relief for violating the Americans with Disabilities Act, as first reported in the Dallas Morning News. The U.S. Equal Employment Opportunity Commission announced the results of its lawsuit against BCBS of Texas this week. According to the lawsuit, a deaf woman named Sheryl Meador applied online to be a claims examiner, and was asked to complete an assessment with an audio portion. The assessment did not have accommodations for hearing-impaired applicants, and Meador was unable to complete it. The… Full Story

Blue Cross Blue Shield of Texas Parent Company More Than Tripled Profits to $4.1B in 2018

Health Care Services Corporation, the parent company for Blue Cross Blue Shield of Texas, did not pay federal taxes in 2018 and netted $4.1 billion, receiving a $1.7 billion tax refund last year, according to financial statements. In 2017, the company had a net income of $1.3 billion, an increase of over 315 percent for this year. The tax overhaul passed by Congress and increasing profitability of health insurance played a large role in the increase, according to Axios. Profits don’t include fees from self-insured employers pay to HCSC, and the Affordable Care Act Marketplace was a big winner for HCSC.… Full Story