BSW/BCBS

2,221 Views | 12 Replies | Last: 4 days ago by MyNameIsJeff
EBrazosAg
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12:38p, 5/8/24
AG
And so it begins….

https://www.kbtx.com/2024/05/08/baylor-scott-white-could-terminate-bluecross-blueshield-contract/
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dubi
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1:32p, 5/8/24
AG
This would suck given that St Joseph is falling to pieces before our eyes.
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Rapier108
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2:25p, 5/8/24
Ugh, they need to come to an agreement which benefits both sides, and their customers/patients, but watch one or the other hold out for some ungodly demand and we're stuck with 2-3 years of anyone with BCBS not being able to use S&W.
"If you will not fight for right when you can easily win without blood shed; if you will not fight when your victory is sure and not too costly; you may come to the moment when you will have to fight with all the odds against you and only a precarious chance of survival. There may even be a worse case. You may have to fight when there is no hope of victory, because it is better to perish than to live as slaves." - Sir Winston Churchill
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Tom Cardy
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2:26p, 5/8/24
AG
I'm not an expert, but it seems like BSW wouldn't want to afford the revenue hit from losing that much of their patient base? Seems like a follow the money situation to me, and some posturing to make it more favorable for someone involved
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althormoon
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In reply to Tom Cardy • 3:38p, 5/8/24
Tom Cardy said:
I'm not an expert, but it seems like BSW wouldn't want to afford the revenue hit from losing that much of their patient base? Seems like a follow the money situation to me, and some posturing to make it more favorable for someone involved


Last time this same thing happened with St. Joe's the insurance and hospitals basically said the BCS market is too small compared to Houston and Austin, which is all they really care to negotiate about. We are just a drop in the bucket. Eventually with St Joes the bigwig corporate people in Houston caved and there was a deal made at the last minute. I'm sure the same thing will happen again. BCS is just caught in the crossfire because of how few providers we have.
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Average Joe
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In reply to dubi • 7:07p, 5/8/24
AG
dubi said:
This would suck given that St Joseph is falling to pieces before our eyes.
That's what happens when CHI comes in and sucks them dry to save other hospitals.
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EBrazosAg
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In reply to althormoon • 7:31p, 5/8/24
AG
I would guess that BCBS is 35-45% of the overall private insurance volume for BSW entity wide, and 65-70% locally. That is probably about the same for CommonSpirit Texas (it's not CHI anymore) but probably a little less considering the BSW Dallas lean and the heavy CommonSpirit Houston lean. That does put the local hospitals and physicians at a bigger risk with these kind of kerfuffles. We are still gnats on the butt if the big state players. Both BCBS and the systems have plenty of good arguments and blame to go around.
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MarineBQ04
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10:10p, 5/8/24
AG
Looking at the actual plans they are dropping, several are related to the gov't…which means they get penny on the dollars anyway. The ParPlan seems like it is a headache and the others are HMO's etc that don't pay out much. Based upon what is listed, TAMU plans seem to be safe.
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JMac03
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10:44p, 5/8/24
AG
I sure hope they fix it. It's hard enough to get in to see doctors now. If they take half of those options away from us we are screwed.
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Hornbeck
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5:25p, 5/9/24
This is a corporate game of chicken between BSW and BCBSTX. I bet it will get worked out, and the party that released that info is wanting the public to apply pressure to make their negotiations more favorable.
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EBrazosAg
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In reply to Hornbeck • 9:31p, 5/9/24
AG
It's a little more complex than that but essentially you are correct- this was all set up in 2012 and is essentially a battle between two entities that could care less about patients or providers or quality or value of care. It's about their margins and profit - even if they profess to be non profit. Also / it's all about DFW. BCS and Waco/Temple are rounding errors in the total $.
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EBrazosAg
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8:56a, 5/15/24
AG
More info

https://www.dmagazine.com/healthcare-business/2024/05/baylor-scott-white-health-to-terminate-blue-cross-clue-shield-agreements-in-july/
No material on this site is intended to be a substitute for professional medical advice, diagnosis or treatment. See full Medical Disclaimer.
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MyNameIsJeff
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9:10a, 5/15/24
AG
As someone with BCBS, an autoimmune disease that requires several thousand dollars of meds monthly, and two young kids that seem to be a continuous stream of Dr. bills, this really stresses me out.

I'm so fed up with dealing with healthcare and insurance bull*****
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