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

The Do’s and Don’ts of Corporate Wellness

Leadership buy-in, authentic employee participation, and building a culture of health are all keys to successful corporate wellness, benefitting the a company’s bottom line as well the health of its employees. These points and more were discussed earlier this month at the North Texas Corporate Wellness Forum organized by the American Cancer Society. The forum consisted of Becky Hall, Senior Manager of Health and Welfare Benefits and Wellness Programs at Oncor Electric Delivery, Dr. Paul Hain, Chief Medical Officer and Divisional Senior Vice President of Market Delivery at Blue Cross Blue Shield of Texas, and Levin Gunter, Lead Benefits Consultant at… Full Story

Blue Cross Teaming Up With 11 Texas Institutions to Address Healthcare Costs

Richardson-based Blue Cross and Blue Shield of Texas will be teaming up with 11 universities to address the root causes of high cost of health care. The research institutions and insurer will be working on projects that focus on behavioral health, vaccine adherence, and analyzing usage data to improve efficiency.  The collaboration is part of Blue Cross’ Affordability Cures initiative, and hopes to address care delivery, unequal distribution, and waste in the system. “Failure to address access and affordability of health care has real consequences. We need to challenge the status quo by bringing transformative research and ideas to the table,”… Full Story

How Much Money Are North Texas Health Plans Making?

The latest version of Allan Baumgarten’s Texas Health Market Review came out this year, revealing enrollment, profit, and marketshare for Texas’ Health Plans for 2017. Some plans appear to be raking in the cash, while others are losing millions of dollars. First, let’s look at what the review says about insured rates in Texas, which has the greatest percentage of uninsured people in the nation. According to the report, Texas’ uninsured rate decreased from 21.9 percent in 2013 to 17.3 percent in 2017, though it ticked up from 16.9 percent since 2015. Texas is one of 14 states that hasn’t adopted… Full Story

Blue Cross Insurance Data Reveals Texas’ Freestanding Emergency Department Charges

New research shows what many have already discovered: freestanding emergency departments may charge more than urgent care centers to fewer patients who have similar conditions. The study looked at three urgent care centers that were converted to FSEDs in Texas using insurance claims from Blue Cross Blue Shield of Texas, based in Richardson. They show that patient volume went down between 29.5 and 94.8 percent, but reimbursement per patient increased between 970 and 1,369 percent. The study showed no significant difference in the age, gender, or conditions of patients managed by both the UCCs and FSEDs. Researchers did find a… Full Story

Community Organizations Awarded $1.8 Million from BCBS of Texas

Blue Cross Blue Shield of Texas has awarded $1.8 Million to community based organizations to fight and and manage chronic kidney disease and chronic obstructive pulmonary disease. Richardson-based BCBS of Texas has awarded more than $10 million Healthy Kids, Healthy Families grants to focus on the two diseases. The two diseases often go hand in hand, and research has shown that COPD increases the risk of mortality for patients with CKD by 41 percent, especially among women and children. “We launched this strategy understanding that this was an opportunity to impact two chronic diseases that are impacting the lives of… Full Story

Judge Dismisses Blue Cross Lawsuit Over Low Reimbursement Rates

A federal judge has dismissed a lawsuit against Blue Cross Blue Shield of Texas by 49 physician groups that claim the insurer is not paying enough for emergency medical care. The groups argue the there are 250,000 claims where Blue Cross’ reimbursement rate for out-of-network providers violates Texas insurance laws and regulations. In an emergency, patients are brought to the nearest hospital, which might not always be in network. “As out-of-network providers, the Provider Entities are not contractually bound to accept discounted rates of payment for the emergency medical services they provide to BCBSTX Members and instead expect to receive… Full Story

Dr. Paul Hain promoted to Chief Medical Officer of Blue Cross Blue Shield of Texas

Dr. Paul Hain has been promoted to be Chief Medical Officer and divisional senior vice president market delivery for Blue Cross Blue Shield of Texas after previously serving as president of North Texas Market Strategy for the insurer. Hain is no stranger to D CEO Healthcare, and isn’t afraid to ruffle feathers. He speaks at medical conferences and panel discussions all over the region, and has spoken passionately about why medical costs are the way they are. In his new position, he will oversee public relations, community investments, government relations, and lobbying efforts. His other roles will include executive sponsor… 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