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65,000 Blue Cross patients to lose in-network access, including at CHI St. Joseph's Health in Bryan

Posted at 12:28 PM, Dec 15, 2020
and last updated 2020-12-15 18:29:15-05

TEXAS — According to the Houston Chronicle, approximately 65,000 Blue Cross Blue Shield of Texas members could lose in-network access to CHI Texas division locations; locations included involve:

  • CHI St. Luke's Houston-area locations
  • Brazosport Regional Health System in Lake Jackson
  • CHI St. Joseph's Health in Bryan

All of which, are set to lose coverage on Dec. 16. should negotiations fail.
In October, the hospital network and insurer announced that they would part ways.

CHI St. Luke's CEO, Doug Lawson, stated at the time Blue Cross Blue Shield of Texas was paying "significantly" less than their competitors for the same hospital system's services.

“Our goal throughout these negotiations has simply been to receive fair reimbursement that will allow us to continue providing critical care to our community," Lawson said in a statement according to the Houston Chronicle.

"All we're asking for is a reimbursement rate that will sustain the value-driven care that so many in Houston depend upon." he added.

“They notified us in June, right in the middle of a global pandemic and economic crisis, that they would no longer be in our network as of December 16, 2020, unless BCBSTX agreed to some pretty unreasonable and high demands that they had to raise their prices,” said Shara McClure, Divisional Senior VP of Texas Health Care Deliveries, BCBSTX this October to 25 news.

According to the Houston Chronicle, Blue Cross Blue Shield has made another offer to CHI St Luke's and is waiting for their response.

“The clock is ticking toward Dec. 16,” said Blue Cross spokesperson James Campbell.

The contract's end would affect all Blue Cross Blue Shield of Texas plans except MyBlue Health; that of which, doesn't expire until 2021.

Currently, CHI St. Luke's joins an expanding list of health systems in Texas who have announced parting with major insurance carriers according to the Houston Chronicle. In 2019, UnitedHealthcare stated they would drop Houston Methodist over disputes on rising health care costs and reimbursements.

However, said contract got extended for several more months, and was later able to get renegotiated for new multi-year contacts.