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(432) 640-4000
(432) 640-4000
(432) 640-4000

Frequently Asked Questions

What is happening between MCH and BCBSTX?

  • As a part of our regular process, MCH and BCBSTX are currently negotiating a new contract in good faith before our current contracts expire on May 31, 2023.

Is MCH going out-of-network with BCBSTX?

  • If we are unable to reach an agreement before our current contract ends on May 31, 2023, BCBSTX would consider Medical Center Hospital, outpatient clinics and physicians to be out of network with BCBSTX insurance plans.

Is there anything I need to do right now?

  • Nothing will change before May 31, 2023. Patients should keep any scheduled appointments and continue to see their MCH providers as normal. It is our strong desire to come to an agreement before the end of May, and we believe BCBSTX shares that same goal.
  • You can help by calling the number on the back of your health insurance card and asking BCBSTX to reach a new agreement to protect your in-network access to MCH, its physicians and outpatient clinics.

Why are fair reimbursement rates so important?

  • As the Permian Basin’s safety-net hospital and leading Level III Trauma Center and leading provider of pediatric care, it is crucial we are able to continue to provide this needed care to our community.
  • Currently, BCBSTX reimburses MCH at rates far less than it pays other health systems in West Texas for the same services.
  • Our goal is to be paid fairly for the services we provide to the communities we serve and to work collaboratively to reach an agreement so there is no disruption in care for our patients. We have every reason to believe that BCBSTX shares the same goal.

Isn’t MCH doing just fine financially? Why do you need a new contract?

  • As you might expect, MCH has not been immune to the after-effects of the COVID-19 pandemic, including the challenging operational and financial pressures many health systems have experienced as a result of unprecedented high labor costs, inflation and the increasing cost of supplies.
  • Even as the cost to deliver care has risen dramatically, MCH has not received an increase in payment from BCBSTX in five years. It is not possible for us to continue serving our patients unless we are compensated fairly for the care we provide.
  • Despite these challenges, we have made significant investments to expand healthcare for our community:
    • Recruited 19 physicians in the last year
    • Added infectious disease and vascular service lines.
    • Invested in $13,950,000 in new equipment

What will happen if an agreement is not reached?

  • We are doing everything we can to come to a fair agreement with BCBSTX. However, if BCBSTX declines to negotiate a fair agreement before our current contract ends on May 31, 2023, BCBSTX would consider Medical Center Hospital, outpatient clinics and physicians to be out of network with BCBSTX commercial insurance plans after May 31, 2023.

What is the hospital doing to protect patients from higher costs?

  • We’re doing everything we can to protect our patients from higher out-of-pocket costs, including offering virtual visits, urgent care options, family health clinics, and a continual review of our insurance contracts to ensure the best rates for our patients. Nothing is more important to us than ensuring our patients have affordable access to the care they need.

If MCH goes out of network with BCBSTX, will patients still be able to receive care at its facilities after May 31, 2023?

  • By law, emergency care is always covered as in-network. While patients can still receive other services from MCH, after May 31, 2023, if we are no longer considered “in network,” BCBSTX may make patients responsible for a significantly greater portion of the cost of their care.

Will patient out-of-pocket costs increase for care provided by MCH when/while they go out of network with BCBSTX?

  • Unfortunately, that would likely be the case for non-emergency services. It’s important to know we are working diligently to bring BCBSTX to the negotiating table to achieve a fair contract and assure our patients can continue to receive their care without disruption. We have every reason to believe BCBSTX shares this goal.

What You Can Do Today:

  • It is important to know that nothing will change before May 31, 2023. Patients should keep any scheduled appointments and continue to see their MCH providers as normal.
  • Call the number on the back of your health insurance card. Ask BCBSTX to reach a new agreement to protect your in-network access to MCH, its physicians and outpatient clinics.
  • If you have employer-sponsored health insurance with BCBSTX, talk to your employer and/or human resources representative about your desire for continued in-network access to MCH, its physicians and outpatient clinics.