TEXAS TRIBUNE ILLUSTRATION by TODD WISEMAN
by BRAD ROLLINS
After negotiations stalled in the days before an April 6 midnight deadline, Central Texas Medical Center and three other Adventist Health System hospitals in Texas have left Blue Cross Blue Shield of Texas’ provider network.
The contractual dispute could mean higher out-of-pocket costs for some of the thousands of Hays County residents covered by Blue Cross, the state’s largest private health insurer.
“This is certainly not the outcome we wanted, but we remain fully committed to working with our patients to continue providing the care they need through their local community hospital,” Sam Huenergardt, the hospital’s president and chief executive officer, said Wednesday in a written statement.
Blue Cross provides health coverage for major local employers such as San Marcos CISD, which employs 1,111; H-E-B Grocery Co. LP, which employs more than 500 at its San Marcos distribution center; Chartwells USA, which employs about 240 as Texas State’s food service concessionaire; and TXI Hunter Cement, which employs more than 100. About 10 to 12 percent of CTMC’s clientele uses Blue Cross health insurance, hospital officials say.
The dispute also affects CTMC Hospice and some of the 20-plus physicians who work with Live Oak Health Partners, a CTMC subsidiary that operates clinics in San Marcos, Kyle, Wimberley and Lockhart.
Citing the insurance company’s “history of underpaying CTMC,” Adventist Health sought substantial increases in the reimbursement rates it receives for treating Blue Cross members. Blue Cross countered with a schedule of more modest increases “in line with what we offer other hospitals in the region,” said Esteban López, Blue Cross’s San Antonio regional president.
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