News Column

County, ACU, AISD among potentially affected by Hendrick-Blue Cross dispute

May 23, 2014

By Brian Bethel, Abilene Reporter-News, Texas

May 23--A total of 529 Taylor County employees -- out of 544 -- are among those that stand to be affected by a rate dispute between Hendrick Health System and Blue Cross Blue Shield of Texas, according to County Judge Downing Bolls.

The county was among a handful of employers that responded to the Reporter-News' requests for comments after the two companies went public with the dispute Wednesday. Taylor County is closely monitoring the situation in hopes that a resolution might be reached, Bolls said.

The two companies are deadlocked over Hendrick's request for a reimbursement rate increase.

At the heart of the dispute, Hendrick is arguing that its medical system has not received a raise in compensation from the insurance company in four years.

"I think what we're asking for is similar rates that are paid to similar-size hospitals that are just like us," said Tim Lancaster, the hospital's CEO, in a news conference. "We think that is a fair request."

But Blue Cross says that Hendrick is asking for a 40 percent raise, a bump officials from the insurance company say would raise members' costs "significantly."

"This would add millions of dollars annually to our members' costs and is the equivalent of 27 times the current rate of inflation," said Dr. Dan McCoy, Blue Cross Blue Shield of Texas chief medical officer, in a statement. "This is something we simply cannot agree to do."

If not resolved by a June 30 deadline, Hendrick services, as well as Hendrick Provider Network (HPN) and Hendrick Anesthesia Network (HAN) physicians, will be considered out-of-network for BCBSTX patients, and probably more expensive for policyholders than in-network services.

Shortly after the dispute was made known, Bolls said he was still learning about the issue.

"We have still not been officially notified by letter or other correspondence, so this came as bit of a surprise," he said Wednesday afternoon. "I only learned about it from news accounts appearing on the Internet. "

Hendrick officials met with the county Wednesday to explain the situation, Bolls said.

"It's still very early and I didn't have a lot of answers given in the meeting -- just that it is a situation that has been developing for several years and that hopefully some progress can be reached by the June 30th deadline," he said. "We are still not sure what the actual cost numbers will be for us because neither side is talking numbers with us."

In addition to the 529 employees covered by BCBSTX, about 300 to 350 dependents of county employees are covered at any one time, Bolls said.

The Abilene Independent School District has more than 1,000 employees who rely on Blue Cross Blue Shield, said Mark Neal, the school district's associate superintendent for Legal & Human Resources.

Blue Cross serves as underwriter for TRS-ActiveCare, the health insurance provider for AISD and "many if not most other school districts in Texas," Neal said.

That will change, Neal said, since TRS-ActiveCare will shift over to Aetna in place of Blue Cross beginning Sept. 1, he said.

"But we remain with Blue Cross through the summer until Aug. 31," Neal said in an email. "So we do hope that Hendrick and BCBS can come to terms in time to avoid an inconvenient and potentially expensive gap for employees who may need or want to use Hendrick services for covered care and treatment this July or August."

The good news, he said, is that Hendrick does already have appropriate agreements in place with Aetna, he said.

In the meantime, Neal said that the district was confident that Hendrick was doing everything it reasonably could to maintain contractual relations with BCBSTX without interruption.

"We hope the parties can work out their differences for the greater good of all concerned," he said. "We appreciate (Hendrick) being cognizant of our employees' needs, both in the short term for this summer and in the near future with Aetna coming in to succeed BCBSTX as underwriter for our insurance coverage."

Wendy Jones, chief human resources officer at Abilene Christian University, said the college has been aware of the situation for several weeks and has identified "viable options that would serve the needs of our faculty and staff in the event that negotiations between Hendrick and BCBSTX are unsuccessful."

"Implementing these options would take some time and there would be a potential for some service disruptions," Jones said in a statement sent to employees and given to the Reporter-News. "We are committed to finding a solution that minimizes the service impact to ACU faculty and staff and their families in a responsible manner."

The college remains optimistic that Hendrick and Blue Cross would reach a resolution, Jones said.

The change to out-of-network status for Hendrick, should it go into effect, is expected to affect about 10,000 households overall, Hendrick officials said Wednesday afternoon, about 10 percent of its patients.

Abilene Regional Medical Center said that its hospital and its employed physicians remain in-network providers for patients covered by Blue Cross Blue Shield of Texas.


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Source: Abilene Reporter-News (TX)

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