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IrishBubbaLiberal

(1,192 posts)
Tue Apr 1, 2025, 04:59 PM Tuesday

Greedy Blue Cross Blue Shield of Texas drops 31 major N.Texas hospitals & systems from its network

Greed.

This Insurance behemoth BCBS refuses to agree to pay what majar hospitals need to get paid…….

BCBS profits come FIRST.
Patients can just can not depend on their insurance to cover
for the doctors that BCBS provided a list for when enrolled in BCBS.

FUCKING GREEDY ASSHOLE MEDICAL INSURANCE EXECUTIVES.



———-

The Southwestern Health Resources network includes 31 hospitals….

https://www.keranews.org/health-wellness/2025-04-01/blue-cross-blue-shield-of-texas-drops-major-north-texas-hospital-system-from-its-network

Blue Cross Blue Shield of Texas drops major North Texas hospital system from its network

Published April 1, 2025 at 1:49 PM CDT

Blue Cross Blue Shield of Texas will no longer cover medical services through one of North Texas' largest health care networks, according to a statement from the insurance provider.

Contracts between BCBSTX and Southwestern Health Resources expired Wednesday after unsuccessful contract negotiations over reimbursement rates and other terms.

"We understand and are sensitive to the difficulties hospitals are facing with labor, supply and other cost pressures," an unnamed BCBSTX spokesperson wrote in a statement to KERA. "Unfortunately, we couldn't reach an agreement that protect the interests of our members and customers, who are facing those same pressures.

"We value SWHR's services and remain committed to reaching an agreement that appropriately balances the concern with affordability and access for our members."

Southwestern Health Resources includes Texas Health Resources and UT Southwestern. The expired contract affects more than two dozen North Texas hospitals, as well as numerous surgery centers, behavioral health facilities and imaging facilities.

More…….

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https://www.dmagazine.com/healthcare-business/2025/04/utsw-thr-officially-out-of-blue-cross-blue-shield-of-texas-network/

The pages of D CEO Healthcare said it would likely never happen, but we were wrong. Southwestern Health Resources is officially out of network with Blue Cross Blue Shield of Texas, as the state’s largest insurer and region’s top hospital failed to agree to a contract by the April 1 deadline. And no, this isn’t (as far as we know) an April Fool’s joke.

This iteration of contract negotiations has been rumbling with trouble brewing between the two entities since the end of last year, when members were contacted by Blue Cross Blue Shield of Texas and told that its negotiations with Southwestern Health resources were not going well and that members would be out of network with SWHR on April 1. SWHR is an accountable care organization that includes the health systems of UT Southwestern and Texas Health Resources.

Today, the contract expired. “SWHR hospitals, facilities, doctors, and health care professionals are currently no longer in our networks,” a statement from BCBSTX said. “We understand and are sensitive to the difficulties hospitals are facing with labor, supply, and other cost pressures. Unfortunately, we couldn’t reach an agreement that protects the interests of our members and customers, who are facing those same pressures.”

…….(………….)……

The negotiations are a battle of Goliath and Goliath. The Southwestern Health Resources network includes 31 hospitals, more than 7,000 physicians, and other providers who provide care for more than 750,000 individuals across 16 counties in North Texas. According to the Kaiser Family Foundation, BCBSTX is the largest insurer in the state, with a 52 percent market share. United Health Group is the second largest at 30 percent of the market. BCBSTX says it provides coverage to 5.1 million Texans.

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Greedy Blue Cross Blue Shield of Texas drops 31 major N.Texas hospitals & systems from its network (Original Post) IrishBubbaLiberal Tuesday OP
Look at the $$$ involved...... IrishBubbaLiberal Tuesday #1
The term Profit tells ya everything ya need to know MagickMuffin Tuesday #2

IrishBubbaLiberal

(1,192 posts)
1. Look at the $$$ involved......
Tue Apr 1, 2025, 05:11 PM
Tuesday

(………)

According to the Texas Health Market Review, both organizations remain profitable. Texas Health Resources saw an 11 percent profit margin on $5.4 billion in patient revenues in 2023, and the University of Texas system had a 9.8 percent margin on more than $10 billion in revenue across the state. The review found that BCBSTX’s HMO plan had the healthiest profit margin of 4.5 percent on more than $308 million in revenue in 2023. But according to research firm Mark Farrah and Associates, BCBSTX’s parent company Health Care Services Corp., which covers 26 million lives nationwide, saw a significant decline in profitability between 2023 and 2024. Between the third quarter of 2023 and the third quarter of 2024, HCSC’s profit margin dropped from 3.9 percent to 1 percent.

MagickMuffin

(17,524 posts)
2. The term Profit tells ya everything ya need to know
Tue Apr 1, 2025, 06:07 PM
Tuesday


Healthcare is driven by profits, that’s the reason they exist.


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