BCBSTX comments on contracting with FSERs

Following the media coverage on costs associated with free standing emergency rooms (FSERs), an active legislative session on the topic, and our recent interview with leadership at Code 3 ER, we reached out to Blue Cross and Blue Shield of Texas.

I wanted to better understand how BCBS thinks of FSERs in terms of its provider network, and the efforts they’ve made to find a negotiated in-network rate with FSERs to protect consumers from surprise out of network charges.

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Here is the statement BCBSTX sent me:

Over the past four years, BCBSTX has reached out to all FSERs who are licensed through the Texas Health and Human Services Commission. The efforts of this outreach resulted in approximately 18 non-hospital affiliated FSERs becoming part of a BCBSTX network.

Unfortunately, being true to their out of network business model, many of the remaining facilities outright rejected any substantive discussions with BCBSTX.  Those rejections came even before being provided our payment rates.  We remain willing to enter into contract discussions with any facility, including FSERs, for network participation at reasonable mutually agreeable rates.

A review of the BCBS provider directory shows there are 24 FSER sites in the provider network that are within 100 miles of Dallas.

Of those sites, 20 are part of Texas Health Hospital. This is a chain of FSERs that, I’m told, were formally part of Texas Health Resources (THR), but which have changed ownership in recent years. These sites are not listed at the THR website as part of the facility network.

An additional three sites are part of the UT Health System. One site, Ecare Emergency Center Frisco, appears to be closed.