Following a monthslong dispute over reimbursement rates, insurance provider Blue Cross and Blue Shield of Texas and health network Baylor Scott & White Health have reached a contract agreement regarding health provider and facility contracts. 

The agreement means Baylor Scott & White’s Central and North Texas providers and facilities will remain in the network of patients who are covered by Blue Cross and Blue Shield health insurance. This includes the health system’s hospitals, clinics, ambulatory surgery centers, imaging centers, surgery centers and urgent care facilities. 

On its website, Blue Cross and Blue Shield stated the agreement protects patients’ “access to quality care at fair prices.”

“Our goal is to protect your health care dollars and give you access to quality care at affordable rates,” the health insurance company wrote. “As a customer-owned health insurance industry leader in Texas for nearly 95 years, we take our responsibility as your advocate very seriously.” 

A spokesperson with Baylor Scott & White told the Report that the two companies “share a commitment to our communities and are proud to preserve their choice of high-quality, in-network providers.” 

Baylor Scott & White and Blue Cross and Blue Shield did not answer the Report’s specific questions about the contract and reimbursement rates. 

Blue Cross and Blue Shield serves nearly 8 million people across Texas. The health insurer is the largest in Texas and nearly double the size of the next-largest health insurance company, UnitedHealthcare, which serves more than 4.7 million across the state. 

Baylor Scott & White operates more than 50 hospitals and 800 patient care sites, and has over 7,000 physicians in its network. The health system reported over $1.22 billion in revenue in 2022. 

In mid-June, a Blue Cross and Blue Shield spokesperson told the Fort Worth Report the health insurer was notified that Baylor Scott & White would terminate its contract “unless we significantly increase what we pay them.” 

Patients were notified through mail and emails that the two companies were working to reach an agreement by July 1. 

A week later, the two companies reached a temporary agreement to extend health provider and facilities contracts to Oct. 1 as they continued working to finalize a longer-term agreement. 

The dispute over reimbursement rates remains an industrywide issue, as growing labor and supply costs put financial strains on health care facilities. 

In early 2020, UnitedHealthcare faced similar contract disputes with Houston Methodist. The two companies ended their in-network contract for nearly five months until a new contract was approved in May of that year, according to The Dallas Morning News. 

While other businesses and industries can raise prices when labor costs increase, the same scenario does not apply in health care. Providers who rely on insurance payments can only increase prices during contract negotiations with payers, when they decide on reimbursement rates. 

As documents related to the contract are finalized, Blue Cross and Blue Shield said patients will continue receiving uninterrupted, in-network care from Baylor Scott & White. 

David Moreno is the health reporter for the Fort Worth Report. His position is supported by a grant from Texas Health Resources. Contact him at david.moreno@fortworthreport.org or @davidmreports.

At the Fort Worth Report, news decisions are made independently of our board members and financial supporters. Read more about our editorial independence policy here.