Ascension Texas, Blue Cross Blue Shield of Texas reach new agreement on services and coverage for central Texas members

FILE GRAPHIC: Blue Cross Blue Shield
FILE GRAPHIC: Blue Cross Blue Shield((KWTX))
Published: Jan. 17, 2023 at 4:31 PM CST
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WACO, Texas (KWTX) - UPDATE: The Ascension Texas health care network and Blue Cross and Blue Shield of Texas reached a new agreement for hospital, hospital-based clinic services and ambulatory surgery centers, Ascension Texas confirmed.

“This means that the contract for these services will not end on January 31, 2023, and there will be no interruption in access for BCBSTX members who seek care at Ascension facilities,” the health network said in a news release.

This means Blue Cross Blue Shield Texas members will continue to have in-network access to all Ascension providers, including Ascension Seton, Ascension Providence, hospital-based clinic services, Dell Children’s Medical Center, Ascension Medical Group practices and select joint-venture facilities.

“We are pleased that BCBSTX members – our patients – will have continued access to the world-class care and high-quality, advanced services only available through Ascension Texas,” the health network said.

ORIGINAL ARTICLE: The Ascension Texas health care network and Blue Cross and Blue Shield of Texas are locked in ongoing contract negotiations that, if unresolved by the end of January, could affect the coverage of thousands of Central Texans.

Ascension Texas, parent company of facilities in Waco, Austin and Round Rock, confirmed in a statement it continues to work with Blue Cross on new contract terms “that will ensure BCBSTX policyholders maintain in-network access to Ascension Texas hospital, physicians, and hospital-based clinics including Dell Children’s Medical Center, and select joint venture facilities, including Ambulatory surgery Centers.

“Without a commitment to reasonable terms, our current agreement with BCBSTX will end on January 31, 2023, for BCBSTX’s Commercial and Medicare Advantage members,” the statement said.

Blue Cross and Blue Shield of Texas said in a statement that it continues negotiations with Ascension, but cautioned that without a new agreement, “Ascension hospitals and surgery centers in Austin and Central Texas will leave most BCBSTX networks on Feb. 1.”

“We value the care Ascension provides our members, but it is already one of the most expensive health systems in the Austin and Central Texas area,” the Blue Cross statement said. “As a customer-owned health insurance industry leader in Texas for more than 90 years, it is important to stand up for affordable care, especially in a time when most businesses and our members in the Austin and Central Texas region are facing inflationary pressures and a potential recession.”

Without a new contract, Ascension hospitals will leave Blue Choice PPO, Blue Essentials, Blue Advantage HMO and Medicare Advantage PPO networks on May 1, while doctors and health care professionals would leave the Blue Advantage HMO network on June 15, according to the statement.

Blue Cross and Blue Shield of Texas touts itself in the release as “the largest provider of health benefits in the state, working with nearly 80,000 physicians and health care practitioners and 500 hospitals to serve 6 million members in all 254 counties.”

If Ascension Texas and Blue Cross fail to reach an agreement, Blue Cross pledged to “do everything we can to help members move their care to quality, cost-effective, in-network hospitals and health care professionals.”

Blue Cross members being treated for pregnancy, disability, acute conditions or life-threatening illness may qualify as a “continuity-of-care patient,” according to the Blue Cross statement.

“This means they may still be able to receive care at in-network rates at Ascension even after it leaves our networks,” the statement said.