Similar information will be shared with employer groups.
The contracts between Blue Cross and Blue Shield of Texas (BCBSTX) and both Texas Health Resources (THR) and Texas Health Physicians Group (THPG) will expire on Dec. 31, 2016. THR and THPG’s service area spans the Dallas-Fort Worth metroplex. Unless all of the parties reach agreement on new contracts before then, THR and THPG will no longer be part of BCBSTX’s networks effective Jan. 1, 2017.
Our hope is that THR and THPG will begin contract discussions with us so that we can do what is right for our members. We’ve made an effort to initiate these discussions. To date, THR and THPG’s only response to us has been to request that a joint venture, a new clinically integrated health care network, negotiate on their behalf.
BCBSTX does not negotiate with clinically integrated networks or joint ventures that do not legally own and control the entities on behalf of whom they are negotiating. This is because, as we’ve seen time and again, these types of business relationships are often created to provide the leverage necessary to command higher reimbursement rates from insurers. Higher reimbursement rates result in higher costs for members. As a customer-owned industry leader in Texas for more than 80 years, we are committed to advocating on behalf of our members for high-quality, cost-effective health care. It is an obligation we take very seriously.
Should THR and THPG decide to leave our networks, members in North Texas will still have access to more than 25,000 in-network doctors and more than 60 in-network hospitals throughout the area.
Because the outcome of these negotiations is unknown, our immediate focus will be on minimizing the impact to our members. We will work with physicians in the area to transition our members to other hospitals and facilities in the network. We also understand changing to another doctor can be difficult; we are here to help members in this process.
Members who are planning to undergo a surgery or procedure or who would like to know their options for in-network care, can visit our Provider Finder® to locate a new provider in the area. They can register for or log in to Blue Access for MembersSM for personalized search results based on their health plan and network. Members can also call the Customer Service number on their member ID card for assistance.
We will keep you updated on the situation. Please contact your BCBSTX representative with questions or concerns.