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DALLAS—GuideStone Financial Resources is monitoring the potential impact of a payment increase battle between Blue Cross Blue Shield of Texas and Hospital Corp. of America, which could affect around 22,000 Southern Baptist pastors, church staff, seminary students, denominational employees, and their families. BCBS and HCA, one of the nation’s largest hospital chains, are seemingly at a stalemate on a new contract, with a May 1 deadline approaching.
“While we are not directly involved in the negotiations, we are working with Highmark Blue Cross Blue Shield, which serves GuideStone, to communicate with our affected participants and will be communicating with them in the coming days and weeks, as necessary, to keep them informed of their options and rights,” Timothy E. Head, executive officer for denominational and public relations at GuideStone, told the TEXAN.
Contract disputes like this between insurers and providers are not uncommon, Head said, but if an agreement is not reached by the deadline, HCA’s nearly 40 Texas facilities would be dropped from the network at the end of April.
“There is no change in the benefits offered by GuideStone,” Head said. “Members will still have access to alternative in-network providers. Most HCA facilities in Texas are in large metropolitan areas, such as Dallas-Fort Worth, so there are multiple options for high-quality care, sometimes in very close proximity.
“If a contract is not reached, as of May 1 care at HCA facilities will be paid at the out-of-network benefit level, which will require larger cost sharing for the participant. There are several exceptions to this, including those in the middle of treatment for certain conditions, including pregnant women beyond 24 weeks, cancer treatments and other ongoing medical needs, as well as emergency care.”
Given the exceptions and the fact that less than 5 percent of GuideStone’s Texas health plan participants had clams at an HCA-affiliated facility over the past 12 months, Head expects that majority of participants will be “relatively unaffected” by the change.
At the same time, he said, “Talk to your doctor about your concerns if you’ll be going in for scheduled surgery or treatment; many doctors have admitting privileges at multiple hospitals and facilities, in large part due to some facilities being parts of some payer networks but not others.
“We always encourage our participants to avail themselves of the resources at highmarkbcbs.com. The website offers numerous helpful tools, including a provider look-up to help participants locate facilities that they may consider before having scheduled procedures. Participants should also communicate with facilities in advance of scheduled treatment to determine if they will receive in-network benefits.”
