Patients in limbo can breathe a (small) sigh of relief. Baylor Scott & White Health and Blue Cross Blue Shield of Texas have reached an agreement to extend their provider and facility contracts until October 1, 2024, meaning the two have more time to iron out their details before pushing the insurer’s customers out of network.
The two organizations made a joint statement regarding the agreement, which they hope will precede a long-term contract. For the next three months, Baylor Scott & White providers, hospitals, and other facilities will remain in network for the roughly 5 million Blue Cross Blue Shield of Texas members.
“Baylor Scott & White and Blue Cross and Blue Shield of Texas share a commitment to the health and well-being of the patients and members we serve,” the statement read.
A contract between a hospital and an insurance company is usually set for two years, and the three-month extension will allow for more time to find common ground on reimbursement rates. While a relief to those needing immediate treatment, the extension will just delay the anxiety of patients dealing with long-term medical issues.
A D CEO Healthcare reader reached out this week to share about their daughter’s double mastectomy, which is scheduled for July 1. The patient received notice from Baylor Scott & White that they would tell her whether it was considered in or out of network on the day of the surgery. While it seems that this individual surgery will be in-network, those with ongoing treatment extending beyond October 1 will have more to worry about. “This shouldn’t be legal,” wrote the patient’s mother, who asked not to be identified. “I know for certain, it isn’t ethical.”
Despite the current disagreements, Baylor and Blue Cross have a long history. The entity that is now Blue Cross Blue Shield was formed out of Baylor University Medical Center in Dallas in 1928 when a former Dallas school superintendent took on a role with Baylor University leading the Dallas hospital units. He created a plan allowing teachers to contribute to a fund guaranteeing them up to 21 days of hospital care at Baylor in Dallas. The “Baylor Plan” was the original commercial insurance plan.
Both companies seem to be continuing to grow and expand. Baylor Scott & White Health is undergoing a massive expansion on its Waxahachie hospital, and a Baylor University Medical Center trustee said they are exploring a capital campaign for a huge remodel of the system’s flagship campus.
Blue Cross Blue Shield of Texas’s parent company has been expanding with new offices in Houston, Chicago, and elsewhere over the last year. Blue Cross/Blue Shield also spends more money lobbying Congress than all but four other organizations nationwide.
As predicted, the two sides reached an agreement before the deadline passed. An unresolved conflict would likely be catastrophic for either side, so there is existential pressure on both Baylor and Blue Cross to find a solution. If history holds, October will bring another extension or a long-term agreement.
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