KILLEEN (April 9, 2014) Effective Monday, Metroplex Hospital in Killeen and Rollins Brook Community Hospital in Lampasas were no longer part of the Blue Cross Blue Shield of Texas network, which means thousands of residents will have to pay higher out-of-network fees for service, the Metroplex Health System announced Wednesday.
Those covered by Blue Cross Blue Shield still have access to emergency services at the two hospitals at in-network rates, but other services are now out-of-network.
The two hospitals offered to accept a proposal from the insurer, provided that Blue Cross Blue Shield agreed to allow a third party to confirm that the rate for services was fair and in line with what other hospitals in the market are paid, Metroplex said.
“Unfortunately, BCBSTX rejected the offer and chose to let the contract end, impacting thousands in the community,” Metroplex said in a press release Wednesday.
The sticking point in the negotiations was the insurers “history of underpaying Metroplex and Rollins Brook hospitals,” Metroplex said.
Neither hospital has received a rate increase from Blue Cross Blue Shield “in a number of years,” Metroplex said.
"This is certainly not the outcome we wanted, but we remain fully committed to working with our patients to continue providing the care they need with their local community-based hospital," said Carlyle Walton, president and CEO of Metroplex Health System.
"We are working diligently to help BCBSTX members understand their options and ensure a smooth transition."
Blue Cross Blue Shield, however, said Adventist Health Systems, which operates the two hospitals, decided to leave the network.
"Adventist's decision to leave our network is unfortunate but we are fully committed to minimizing any inconvenience this causes our members," said Dr. McCoy, BCBSTX chief medical officer.
"We have a commitment to our employer groups and members to provide access to quality, affordable health care benefits," he said.
"Adventist requested a reimbursement rate more than 10 times the current rate of inflation that would have added more than $5 million annually to the costs of our customers. This is in addition to the 40 percent profit margin that Adventist already makes providing care to our Blue Cross members."
Seton Medical Center Harker Heights and Scott & White Memorial Hospital in Temple are both part of the Blue Cross Blue Shield of Texas network, the company said.
Residents covered by Blue Cross Blue Shield of Texas who have questions about their options can call (817) 551-2701 or go to the Metroplex Health System website.
Metroplex has also posted a list of the health care companies with which it has participation agreements.
Blue Cross Blue Shield, meanwhile, has posted a list of other providers in the area that are in its network.