KelseySeybold back in BCBS fold
Health system rejoins Blue Cross network after abrupt 2016 drop
Kelsey-Seybold Clinic will again be part of the network of Blue Cross and Blue Shield of Texas beginning next year, returning a coverage option that was abruptly halted three years ago for thousands of patients in the Houston area.
Both Kelsey-Seybold, a large local health system of doctors and facilities, and Blue Cross and Blue Shield, the state’s largest insurer, said Wednesday they had reached a contract agreement that would mean lower, in-network rates for Blue Cross and Blue Shield members. Those with Blue Essential health maintenance organization (HMO) plans and Blue Choice preferred provider organization (PPO) plans will have in-network status at Kelsey-Seybold starting Jan. 1.
The announcement comes three years after the provider system and insurer abruptly parted ways, leaving as many as 100,000 area patients scrambling for new in-network doctors or paying significantly more for their care.
“We are pleased that we have reached an agreement with Kelsey-Seybold Clinic enabling us to offer their coordinated care to our members,” Dr. Dan McCoy, Blue Cross and Blue Shield president, said Wednesday in a statement. “The contract reflects our mutual commitment to meeting the needs of our members and their patients.”
Blue Cross and Blue Shield’s leadership praised the KelseySeybold model of value-based care, where payment is tied to overall patient outcome and efficiencies in treatment rather than the old model of payment based on the volume of services provided.
“Health care in this country continues to evolve,” said Dr. Bob Morrow, president of the Houston and Southeast Texas office for the insurer, on Wednesday. “Our resolve to work on collaborative and holistic approach for our members has only increased.”
While Morrow was not specific about what changed in the three years since his company and Kelsey-Seybold parted ways before, he said talks had
continued throughout and there was “mutual respect” on both sides.
“We are excited to be in-network with Blue Cross and Blue Shield of Texas and offer our proven model of accountable care to patients, families and employers in the region,” said Dr. Tony Lin, chairman of Kelsey-Seybold in a statement.
Kelsey-Seybold was founded in Houston in 1949 and now has more than 400 physicians and health professional at 21 locations across Greater Houston area.
This latest announcement
comes in the midst of a volatile insurance climate in Houston.
Last month Community Health Choice, a regional insurer, and Kelsey-Seybold announced the end to their longstanding contract, potentially affecting several thousand patients. Also last month UnitedHealthcare ended its contract of two decades with Houston Methodist’s system of hospitals and facilities, throwing network status for more than 100,000 into jeopardy. That contract will expire Dec. 31 but negotiations are continuing, said a spokeswoman for Houston Methodist.