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

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

Blue Cross Blue Shield Teams Up With Texas A&M to Improve Rural Healthcare

In order to address rural healthcare challenges, Blue Cross Blue Shield of Texas is partnering with Texas A&M University in order to learn more about the problems that face these underserved communities and find solutions to solve them. BCBSTX is committing $10 million to the Texas A&M Health Science Center to reduce healthcare costs and improve outcomes by improving health disparities and social determinants of health. They will join other organizations that are working to improve rural healthcare, such as the Dallas-Fort Worth Hospital Council Foundation, who received a Community Mental Health Grant to provide mental health first aid training… Full Story

Blue Cross Blue Shield, UT Southwestern, Texas Health Resources Team Up to Provide Care in North Texas

Blue Cross Blue Shield of Texas and Southwestern Health Resources are coming together to form an Accountable Care Organization that will coordinate services to serve Blue Cross’ more than 130,000 members in North Texas, according to Pharmiweb. The agreement provides access to Southwestern Health Resources Accountable Care Network, which was established as a partnership between Texas Health Resources and UT Southwestern Medical Center that includes doctors, caregivers, hospitals and other facilities throughout the region. An Accountable Care Organization is a group of healthcare providers who voluntarily join to coordinate care to medicare patients. They hope to avoid duplication and errors… Full Story