The Houston region's largest hospital system and Texas' largest health insurer ended their contractual standoff Friday, announcing they had reached an agreement for a four-year contract renewal that will keep healthcare costs lower for their mutual customers.
A previous agreement between Memorial Hermann Health System and BlueCross BlueShield of Texas (BCBSTX) had expired March 1, meaning Memorial Hermann patients with BCBSTX insurance had to pay out-of-network costs or find new doctors in order to pay in-network prices for medical services. Memorial Hermann has more than 3,000 physicians in its system and operates more than 265 healthcare facilities, including Memorial Hermann Greater Heights Hospital at 1635 N. Loop W.
Now that the two parties have reached a new agreement, Memorial Hermann said in a statement on its website that in-network access has been restored for patients with "BCBSTX commercial PPO/POS, EPO, Blue Essentials HMO and Medicare Advantage HMO/PPO health plans." BCBSTX said in a statement that the agreement also will expand "future access to Memorial Hermann providers for our Blue Advantage HMO members."
"We have great respect for Memorial Hermann," BCBSTX added. "The health system has an important and vital role in delivering care to our members and patients. We are happy to continue our longstanding relationship with the health system."
For Memorial Hermann patients and BCBSTX customers who might have received out-of-network services during the 10-day period when a contract was not in place, Memorial Hermann said those patients should call the member services phone number on the back of their BCBSTX member identification cards. The hospital system also said HMO patients who switched primary care providers during the break in in-network coverage, who wish to transfer back to their previous provider, should call the BCBSTX member services number as well.
"We are reinstating members/patients with no lapse in effective date; and most, if not all, the claims will be reprocessed," BCBSTX spokesperson Carrie Kraft wrote in an email.
Although their months-long negotiations did not produce a new agreement before the previous one expired, both the health system and the insurer both said they had remained committed to working out a deal.
"BCBSTX’s commitment to the sustainability of our health system, our physician network, and our Accountable Care Organization is integral to the health and wellbeing of the many communities we have proudly served for more than a century," Memorial Hermann said. "It is our distinct honor and privilege to continue delivering these services as in-network providers, for all those who need us, for many more years to come."