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Blue Cross, Texas Health Resources reach contract agreement

12/18/2010 7:05 AM

12/18/2010 7:27 AM

Blue Cross and Blue Shield of Texas and Texas Health Resources --- operator of the Harris Methodist, Arlington Memorial, Presbyterian systems – said they reached a multi-year agreement that keeps Texas Health facilities and physicians in the Blue Cross network.

The two had been heading toward a Dec. 31 deadline on negotiations over a new contract. With no agreement after the deadline, Texas Health Resources facilities and some physicians would have been considered out-of-network for Blue Cross customers.

The new contract provides incentives for improving the quality of patient care, and “other pay-for-performance elements to enhance alignment among hospitals, physicians, Blue Cross, employers, and patients,” Blue Cross and Texas Health Resources said in a release Friday night.

Blue Cross and Texas Health Resources weren’t more specific about what’s in the contract. Texas Health has said it was asking for a modest increase in reimbursement that was inside the rate of medical inflation.

“Both parties recognize our shared responsibility to make sure North Texans have convenient access to quality care while also improving patient outcomes and reducing costs in the long run,” Douglas Hawthorne, Texas Health CEO said.

“Working together, we can transform health care reimbursement through innovative payment arrangements such as pay-for-performance and shared savings which can lower costs and improve quality,” Hawthorne said.

Darren Rodgers, president of Blue Cross and Blue Shield of Texas, said “our number 1 priority was improving the value our members receive for health care services by striking an agreement which focuses on pay for performance. The new agreement focuses both parties on improving the long-term affordability of health care services.”

The new contracts will provide more than 1.3 million Blue Cross members with access to in-network health care services at Texas Health’s 24 hospitals and 18 outpatient facilities in the North Texas area.

The contract will provide "uninterrupted" access to the Blue Cross network at Texas Health Resources hospitals and employed physicians, Blue Cross and Texas Health Resources said.

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