Blue Cross Blue Shield of Texas customers can once again receive in-network rates at St. Joseph hospitals after three weeks of being unable to do so because of a pricing dispute between the two entities.
In a Friday night press release, St. Luke’s Health announced that it came to an agreement with BCBSTX, bringing back coverage for 65,000 BCBSTX patients who use hospitals in the St. Luke’s Health network. The new agreement went into effect Friday.
CHI St. Luke’s Health, whose parent organization is CommonSpirit Health, is made up of 16 hospitals across Houston, Bryan-College Station and East Texas, including the Bryan and College Station CHI St. Joseph hospitals.
“This new contract is an affirmation of how important the choice to receive the accessible, value-driven medical care that we provide at St. Luke’s Health is to the health of our community,” Douglas Lawson, CEO of St. Luke’s Health, said in the release. “The support St. Luke’s Health received from patients, providers, employers and other leaders was tremendous.”
On June 17, CHI St. Luke’s Health issued BCBSTX a 180-day notice of termination with intent to renegotiate. In October, Lawson said that Blue Cross Blue Shield of Texas reimbursement rates are 25% or more below competitors’ rates. He said without an increase in rates, the hospital’s ability to function properly could be compromised.
Since the two entities did not reach an agreement by Dec. 16, the contract between them was terminated.
Last night’s press release does not directly address specifics of the agreement that the health insurer and hospital came to, but Lawson said that the contract addresses the hospital’s financial concerns.
“Termination of the contract last month was a difficult decision, especially in the face of COVID-19, but we knew it was a necessary decision as we could only continue to provide the value-driven care our community relies upon by addressing St. Luke’s financial health,” his statement reads. “This agreement does that.”
Last month, BCBSTX said in a release that CommonSpirit Health was requesting double-digit increases in the prices that BCBSTX members pay. Moving forward with the amount that CommonSpirit requested would have driven up the cost of health care in the Houston area and southeast Texas region, Shara McClure, BCBSTX’s divisional senior vice president for Texas Health Care Delivery said in the December release.
Today, Blue Cross Blue Shield said via email that it worked hard to keep prices for members affordable.
“We advocated on our members’ behalf to keep health care prices affordable, particularly during a global pandemic when access to care is critical,” said McClure.