Hendrick, Blue Cross fail to reach agreement, again

Oct. 16--ABILENE, Texas -- Hendrick Medical Center and Blue Cross Blue Shield of Texas once again failed to reach an agreement in a monthslong conflict over reimbursement rates, both parties confirmed Wednesday.

Louis Adams, a spokesman for Blue Cross, confirmed Wednesday that a meeting had taken place in Abilene, and both Blue Cross and Hendrick confirmed no deal had been reached.

Both entities expressed disappointment in the lack of an agreement. Hendrick will be an out-of-network care provider for Blue Cross Blue Shield members the rest of this year and likely through 2015, according to a Hendrick news release.

"We are disappointed in BCBS' decision not to restore in-network access to the largest and most comprehensive hospital in a 150-mile radius of Abilene," said Tim Lancaster, president and CEO of Hendrick Health System, in a statement.

"We sought a contract that treated Hendrick fairly in the West Texas market for a hospital of our size and that recognized our continued investment in expert care and advanced health care services for our community," he said.

In a statement from Carrie Holmstrom, public relations coordinator with Blue Cross and Blue Shield, the insurance provider said it was "deeply disappointed" that Hendrick had not "chosen" to participate in its provider networks.

"We've remained firm in our commitment to hold down costs for our members and we're gratified that so many of them have reached out to let us know they support our decision," Holmstrom wrote in an email.

The insurance carrier and the hospital system have been attempting to reach an agreement with each other for about four years, hospital officials have previously said.

The move means Hendrick patients with Blue Cross Blue Shield of Texas insurance continue to face higher out-of-pocket costs to receive care at the hospital and from physicians in the Hendrick Provider Network and Hendrick Anesthesia Network.

Hendrick and those affiliated providers went out of network July 1 after negotiations between the entities failed.

BCBS of Texas officials said members can call the customer service number on the back of their member ID cards with questions about transitioning care to "other quality providers in the Abilene community."

The hospital last received a rate increase in 2011, but that was negotiated the year before, Lancaster said previously.

Since then, the companies have come to the brink each time, he said. In July, Lancaster said it has been Hendrick that has stopped talks each time because the hospital didn't want to "put the community through" the uncertainty of the current scenario.

The number of people potentially affected remains unclear.

In a May 21 news conference, Hendrick officials said the situation could potentially affect 10,000 families. Blue Cross Blue Shield officials have released statements saying there are 35,000 BCBSTX members in Taylor County, and as many as 75,000 people if looking at the total area potentially served.

Throughout the process, Hendrick has insisted it only wants to be reimbursed at rates competitive with other hospitals in Blue Cross and Blue Shield's network, while the insurance provider has consistently claimed Hendrick has asked for a 40 percent rate increase for the same level of services.

A statement released earlier in October by Lancaster said that since July 1, Hendrick's goal has been to bring BCBSTX "to the table for negotiations."

"In the last 45 days, Hendrick Medical Center has delivered three proposals to BCBS to restore Hendrick and the Hendrick Provider Network (HPN) and Hendrick Anesthesia Network (HAN) physicians to the BCBS network before Sept. 30, but to no avail," he said, adding that the provider had agreed to a meeting Oct. 15.

"Should the October 15 meeting pass without an agreement in principle, Hendrick Medical Center and HPN and HAN physicians will not be in-network providers for BCBS members for the remainder of 2014, and likely the entire 2015 benefit year," Lancaster wrote Oct. 1.

But Adams said late Wednesday afternoon that the doors were not completely closed for reconciliation, as far as Blue Cross was concerned.

"Our door absolutely remains open and we're happy to continue to visit with Hendrick and continue discussions at any point," he said by telephone Wednesday evening.

Recently, the Abilene City Council voted to switch the city's insurance provider to Aetna in the wake of the disagreement between Blue Cross and Hendrick.

Following staff suggestions, the decision cited a need for city employees and their families to be able to access services provided by Hendrick and Abilene Regional Medical Center equally.

This story has been revised from its original version.

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