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Because of Obama care or just normal contract negotiations?

Posted by on May. 24, 2013 at 11:57 AM
  • 2 Replies
Got this email today, it was sent by my fiancé's job so its a legit email.

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[Blue Cross and Blue Shield of Texas]

News Alert: May 23, 2013

An Update on Memorial Hermann Healthcare System

Blue Cross and Blue Shield of Texas (BCBSTX) has been in contract negotiations with Memorial Hermann Healthcare System (Memorial Hermann) in Houston for the past several months. Negotiations continue in good faith; however, unless we reach a mutually acceptable agreement, Memorial Hermann will no longer be a part of the BCBSTX BlueChoice® PPO/POS, HMO Blue® Texas, Traditional/Par Plan and Blue Medicare Advantage networks effective July 1, 2013.

Memorial Hermann is a large hospital system comprised of nine acute care hospitals, one short-stay hospital, two rehabilitation hospitals, 13 ambulatory surgery centers (ASCs) and several other ancillary providers in the metropolitan Houston area, including Sugar Land, Katy and The Woodlands.

Our goal throughout the negotiation process has been to achieve a reasonable outcome that will allow us to meet our employers’ and members’ expectations that we manage medical cost increases and maintain equity among providers in the area.

BCBSTX monitors our contracts closely to ensure we offer competitive rates to health care providers that also help keep premiums affordable for our members. We have offered Memorial Hermann a fair and reasonable reimbursement rate. BCBSTX negotiates reimbursement rates with providers on behalf of our employer groups and members. Changes in provider reimbursement rates do not change what BCBSTX is paid; they change what our employer groups and members pay.

We are disappointed that our longstanding relationship with Memorial Hermann may soon end. It remains our desire to keep the health system as part of the BCBSTX provider network.

If Memorial Hermann is no longer a part of our network, our priority will be to transition our members to other quality, in-network providers serving our members in the Houston metropolitan area, including Sugar Land, Katy and The Woodlands. Our network of hospitals and physicians in the Houston area remains strong.

We encourage you to share this information with your employees and prepare them for how this may impact them if an agreement is not reached in the near future. We will provide updates on our contract negotiations as they are available. If you have questions, please don’t hesitate to contact your account representative. Members can contact BCBSTX Customer Service by calling the number on the back of their member ID card.

List of Impacted Facilities

Memorial Hermann Hospital


Memorial Hermann Surgery Center Sugar Land


Memorial Hermann Southwest Hospital


Memorial Hermann Surgery Center TX Medical Ctr


Memorial Hermann Northwest Hospital


Memorial Hermann Surgery Center Katy


Memorial Hermann Southeast Hospital


Memorial Hermann Memorial Village Surgery Center


Memorial Hermann The Woodlands Hospital


Memorial Hermann Endoscopy & Surgery Center
North Houston


Memorial Hermann Memorial City Hospital


Memorial Hermann Surgery Center Kingsland


Memorial Hermann Katy Hospital


Memorial Hermann Surgery Center Richmond


Memorial Hermann Sugar Land Hospital


Memorial Hermann Surgery Center West Houston


Memorial Hermann Northeast Hospital


Memorial Hermann Endoscopy Center North Freeway


TIRR (The Institute for Rehabilitation & Research)


Memorial Hermann Surgery Center Woodlands Parkway


Memorial Hermann Rehabilitation Hospital Katy


Memorial Hermann Diagnostic Laboratory


Memorial Hermann Specialty Hospital Kingwood


Memorial Hermann Home Health


Memorial Hermann Surgery Center Northwest


Memorial Hermann Hospice


Memorial Hermann Surgery Center
The Woodlands


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by on May. 24, 2013 at 11:57 AM
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Replies (1-2):
Arwyn724
by on May. 24, 2013 at 12:06 PM

Hard to say. My company negotiates their employee health benefits every year, and in the 9+ years I've worked here I've had 5 different insurance plans. The last two years were 'no change' years, so I don't think Obama had anything to do with my companies decisions over time. 

rfurlongg
by on May. 24, 2013 at 12:45 PM
Contraction negotiations are very common. I renegotiate with my providers on a yearly basis. From that email it is really impossible to say if it was a regular contract dispute or if it is directly related to Obama care.

While I support a great deal of ACA, I feel that one of it's greatest short comings was the lack of addressing issues with ins companies. I am hoping to see some ins reform in the near future.
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