Days before a looming deadline, an agreement hammered out Thursday between an insurer and a hospital chain will allow 4.9 million policyholders in Texas to maintain access to in-network health care at hospitals and clinics in the state.
Blue Cross and Blue Shield of Texas had been locked in months-long negotiations with Hospital Corporation of America, the parent company of the St. David’s system in Central Texas. If the two sides hadn’t reached an agreement by Dec. 31, customers of Blue Cross would have been forced to pay expensive out-of-network costs to get treatment at Hospital Corporation of America properties.
Thirty-nine Texas facilities in places such as Corpus Christi, the Dallas-Fort Worth area, Houston, El Paso, San Antonio and the Rio Grande Valley would have been affected. Nashville-based Hospital Corporation of America also operates the Heart Hospital of Austin and St. David’s hospitals in Austin, Georgetown and Round Rock.
Bob Delahanty, a customer of Blue Cross and Blue Shield of Texas, said he was relieved to hear the news about the agreement.
Calling St. David’s the “premium hospital around here,” Delahanty, 69 of Cedar Park, underwent two heart surgeries at St. David’s this year. He said he got “amazing care” from a staff that was compassionate and highly skilled. Even the food was excellent, said.
“God forbid something should happen, the idea that they are there and I can go there, makes me feel a whole lot better,” Delahanty said.
St. David’s spokeswoman Denise Bradley said in a statement that the successfully negotiated contract will affect Blue Cross and Blue Shield of Texas’ PPO/POS (point-of-service), HMO and traditional indemnity plans.
“St. David’s HealthCare is committed to providing high quality, high value care to the people of Central Texas,” Bradley said. “We’re pleased to renew this agreement and continue to provide (Blue Cross and Blue Shield of Texas) members access to the exceptional care St. David’s HealthCare provides.”
St. David’s HealthCare is included as an in-network provider on some — but not all — of the insurer’s plans on the health care marketplace set up as part of the Affordable Care Act, Bradley said.
Louis Adams, a spokesman from Blue Cross and Blue Shield of Texas, said his organization was pleased to reach an agreement.
“This multiyear agreement provides our members with continued access to HCA facilities across the state,” he said in a statement. “As we’ve done for more than 80 years, (Blue Cross and Blue Shield of Texas) stands by its members in sickness and health, ensuring quality, affordable health care benefits to our members in all 254 counties in Texas.”
Neither officials from Blue Cross and Blue Shield of Texas nor St. David’s would comment on further details of the deal.