Cigna and SWHR Reach a New Three-year Agreement

After coming dangerously close to severing the in-network ties between one of the largest providers and one of the largest insurers in North Texas, Cigna and Southwestern Health Resources have come to an agreement that will keep Cigna members in-network at Southwestern Health Resource facilities for the next few years. The three-year deal became effective on January 1, avoiding an interruption of in-network coverage. The agreement lasts until Dec. 31, 2022, and keeps all Texas Health Resources and UT Southwestern hospitals, facilities, and doctors in-network until then. “Southwestern Health Resources, on behalf of Texas Health Resources and UT Southwestern Medical… Full Story

Cigna Contract with Southwestern Health Resources Could End Jan. 1

The new year may mark the end of a relationship between two of the largest players in the local healthcare industry, as Southwestern Health Resources and Cigna have been unable to agree to a new contract, meaning SWHR will be out of of network for Cigna members on January 1. The conflict centers upon the connection between cost and quality, and how each organization measures them. The conflict could impact hundreds of thousands of people across the region. Over the past 18 months, there have been 136,000 interactions between Cigna members and SWHR, 66,000 of those interactions were at SWHR… Full Story

Dallas Healthcare “Truly is the Wild West”

Dallas is one of the most expensive places to receive healthcare in the country. Combined with Texas’ lack of regulatory oversight of business and high entrepreneurial drive, it is a city that is great for business, but when that business has to pay for healthcare for its employees, it creates a number of challenges. Identifying high value providers, bundling payments, and forming direct contracts are all ways that employers are avoiding unnecessary medical care for their employees, and the costs that come with them. Last month, the Hilton Anatole played host to the Employee Health, Benefits, and Well-Being Congress, where… Full Story

Join Us for D CEO’s Value-Based Care Healthcare Breakfast Panel

In many of today’s medical practices, patients and their insurers pay for the procedures and time spent treating their illness, regardless of the outcome. Whether or not the patient needed that blood test, brain scan, or knee scope, they are paying for it directly or indirectly. While it would be bad business to intentionally stack up unnecessary charges, even the most well-meaning providers are incentivized to provide more medical treatment than is actually necessary because of the fee-for-service model of healthcare. But with skyrocketing health costs adding pressure to the employers and taxpayers who pay for healthcare, new systems have… Full Story

Meet the New Senior Executive Officer at Southwestern Health Resources

Southwestern Health Resources Clinically Integrated Network’s new senior executive officer will be Dr. Andrew Ziskind. The organization serves the healthcare needs of more than 900,000 people across 16 counties in North Texas and includes a 4,000 physician network through its accountable care organization. Southwestern Health Resources was founded in 2015 as a partnership between UT Southwestern and Texas Health Resources and includes 29 hospitals in the region. The network saved $70 million in Medicare spending in 2017, and was the top ranked organization in the country for Medicare savings. “By focusing on innovative strategies that maximize efficient and effective use… Full Story

Southwestern Health Resources Network is No. 1 in the U.S.

The Centers for Medicare & Medicaid Services gave the local Southwestern Health Resources Accountable Care Network a quality score of 100 percent after saving $30 million in 2017. The savings made it the top organization in CMS’ Next Generation Accountable Care Organization model. All 44 ACOs participating in CMS’ most high-risk model saved around $208 million in gross savings according to data from CMS. SHR is a joint effort from Texas Health Resources and UT Southwestern Medical Center whose network includes 30 hospitals and 4,000 physicians. The accountable care network manages nearly 69,000 Medicare beneficiaries in the region, and as CMS… 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

UT Southwestern Now Part of Care ‘N Care’s Health Plan

Care N’ Care Health Plan announced that UT Southwestern Medical Center hospitals and physicians will now be part of its provider network, Business Wire reports. Care N’ Care is a ten-year-old health plan that has more than 10,000 clients in North Texas in its Medicare Advantage HMO and PPO packages. “Having UT Southwestern in the Care N’ Care network will be a tremendous boom for our members as it will provide access to a broader network of hospitals and physicians along with additional added resources that will make healthcare more accessible and affordable,” said Care N’ Care CEO Wendy Karsten via… Full Story

How Fort Worth is Reducing Healthcare Costs for City Employees

Talk to any healthcare executive, and they will discuss “bending the cost curve.” That means most healthcare providers, insurance networks, and employers are hoping just to slow the increase in healthcare costs, not reduce them. But for Fort Worth’s 14,000 employees, dependents, and retirees, their healthcare spending is heading toward being $4.8 million under budget for fiscal year 2018, according to the Dallas Morning News. How are they doing it? The city is offering an option to sign up with  Southwestern Health Resources, an accountable care organization where UT Southwestern and Texas Health Resources have partnered to offer coordinated care.… 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