Aug. 12, 2022

BCBSTX and Southwestern Health Resources Negotiating New Contracts

What’s happening: Southwestern Health Resources (SWHR) sent Blue Cross and Blue Shield of Texas (BCBSTX) a termination notice. Unless we reach new agreements, Texas Health Resources (THR) and UT Southwestern (UTSW) hospitals, doctors and health care professionals will leave our networks on Oct. 4, 2022. Blue Cross and Blue Shield Federal Employee Program^® (FEP^®) members will have in-network access until Oct. 11, 2022.

The big picture: We hope to sign agreements that compensate SWHR fairly while being good stewards of our members’ health care dollars. Our goal is to protect our members and customers while providing access to quality care at affordable rates.

The issue: We value the care THR and UTSW provide our members and have been negotiating in good faith for more than a year with SWHR. We believed we were making progress toward an agreement that would continue to give our members in-network access to SWHR doctors and hospitals. However, SWHR’s notice of termination increased its demands.

Without a new agreement, UTSW and THR doctors and hospitals will leave the following provider networks on Oct. 4, 2022:

• Par Plan
• Blue Choice PPO^SM
• Blue Essentials^SM
• Medicaid
• Medicare Advantage (PPO)^SM
• Medicare Advantage (HMO)^SM

THR doctors and hospitals will also leave the Blue Advantage HMO^SM network on Dec. 18, 2022.

Controlling costs: Dallas-Fort Worth is already the most expensive health care market in Texas with costs that are 16% above the national average. We are committed to standing with our members and not allowing unreasonable increases in the market. 

Finding in-network care: If SWHR chooses to leave our networks, members will still have access to in-network doctors and hospitals throughout North Texas. We will do everything we can to help members move their care to quality, cost-effective, convenient in-network hospitals.

Members have several ways to find in-network care:

• Visit our online Provider Finder^®
• Register for or log in to Blue Access for Members^SM
• Call the Customer Service number on their ID card  

Care for ongoing conditions: Members being treated for pregnancy, disability, acute condition or life-threatening illness may qualify as a continuity-of-care patient. This means they may still be able to receive care at in-network rates at SWHR even after they leave our networks. To find out if they are eligible, members can call the number on their ID card for more information.

Why negotiate: As a customer-owned health insurance industry leader in Texas for 90 years, we work with doctors and hospitals to find solutions that are in the best interest of our members. We advocate on our members’ behalf for high-quality, cost-effective health care. It is a responsibility we take very seriously.  

More information: We’ll notify members 30 days before the contract termination date if we haven’t reached an agreement. For the latest information, visit bcbstx.com/swhr.

Please contact your BCBSTX representative with any questions or concerns.