WNJ Hospital may lose Blue Cross/Blue Shield contract

By: Josh Stevenson Email
By: Josh Stevenson Email

SHERMAN, TX - The future of health care has been a hotly debated topic across the country. Now, that debate has come to Sherman as a hospital system and Blue Cross/ Blue Shield continue to try and work out a deal, before patients get hit with higher costs.

Texas Health Resources or THR operates 13 Hospitals in the Dallas/Ft. Worth Area. In April of this year, THR became co-owner and operator of Wilson N. Jones Hospital, since renamed Texas Health Presbyterian Hospital, Wilson N. Jones.

Now with an end of year deadline looming, THR is in danger of losing its contracts with Blue Cross/ Blue Shield of Texas; which means that all of THR's medical facilities, including Wilson N. Jones would not be considered in-plan for Blue Cross Blue Shield Customers.

In a YouTube video posted on THR's website, Senior Executive Vice President Barclay Berdan, says the company is hopeful that an agreement can be reached by the end of the year, and that for now, Blue Cross members will still have access to health care at THR facilities.

"I want to assure Blue Cross members nothing will change until the end of the year. You can still access care at THR hospitals and Physicians as you have in the past,” Said Berdan.

Another statement released by Texas Health Resources says, “Our most significant disagreement is not the amount Blue Cross will reimburse us in the next three years, it's over how Blue Cross wants to pay for care. Blue Cross wants to give retroactive cash payment of millions of dollars now, instead of reimbursing for care during the term of the future contract."

The release goes on to highlight the fact that Blue Cross Blue Shield currently has more than 7 Billion dollars in reserves, saying, "Our feeling is that if Blue Cross has so much cash in its reserves, they should give a rebate to their customers, the employers and members. Our reimbursements should be tied to the care we provide during the term of the contract,"

In a rebuttal statement Blue Cross Blue Shield of Texas says, they are working hard to reach a reasonable solution before the end of the year, but see the issue differently.

"What's at issue here is Texas Health Resources (THR) demand for an additional $120 million dollars over the next three years for the same level of services they currently provide. This kind of runaway spending on medical care is one of the main causes of higher health insurance premiums for our members," read the Blue Cross Blue Shield Statement.

While both sides say they are fighting to get patients the best health care at the lowest costs, if an agreement isn't made by the end of the year, it is the patient who will pay more, either in out-of-provider fees at THR facilities, or in fuel to travel to hospitals who remain in the Blue cross blue shield network.

Online:

http://www.texashealth.org/body.cfm?id=3894&fr=true

http://membersforafairdeal.com


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