Thousands of Houston patients could pay more or be forced to switch doctors after Memorial Hermann Health System and Blue Cross Blue Shield of Texas failed to agree to a new contract.
The health system is no longer in network for Blue Cross Blue Shield commercial and Blue Advantage Marketplace plans after the sides could not agree to terms by an April 1 deadline, Memorial Hermann said in a statement.
As a result, many patients with Blue Cross Blue Shield plans will need to pay higher out-of-pocket costs for medical services at Memorial Hermann. The health system includes 14 hospitals and hundreds of doctors’ offices and clinics in the Houston area.
Certain patients, such as those who are pregnant or being treated for a disability, acute condition or life-threatening illness, may still be eligible for in-network rates at Memorial Hermann. Those patients should fill out a continuity of care request form or call the phone number on their insurance card, the health system said.
Memorial Hermann accused the insurer of asking for “unreasonable demands” and dragging out talks until the April 1 deadline as a negotiating tactic. The reimbursement rates and contract language that Blue Cross Blue Shield proposed during negotiations “ignore the financial realities facing health systems today,” Memorial Hermann said in its statement.
“We will not prioritize a for-profit insurer’s bottom line over the best interests of our patients, providers, employers and employees,” Memorial Hermann said in the statement.
Memorial Hermann accused Blue Cross Blue Shield of employing similar tactics in contract talks with health systems across the United States, including several in Texas.
Hospitals and insurers routinely negotiate contracts that set reimbursement rates for medical services. But those talks have become more contentious as health care costs have risen in recent years, according to NBC News.