Struggling Rural Hospitals Say They're Being Preyed Upon by Blue Cross Blue Shield
It’s hard to keep a hospital running in Iraan, a dusty community of 1,229 people in the middle of the West Texas oil patch. In the 2017 fiscal year, Iraan General Hospital lost $1.1 million; in 2018, it lost $1.2 million, the result of small patient loads, the state’s refusal to expand Medicaid and years of financial mismanagement.
With mounting losses, the hospital’s board recently brought on Keith Butler, a hospital administrator with 38 years of experience, to stop the bleeding. The new interim CEO had just started this spring when he was faced with an unexpected crisis: Blue Cross Blue Shield of Texas, the gargantuan health insurance company that claims one-quarter of the marketplace in the state, sent Butler a letter asking to renegotiate its contract with the hospital. Attached was a new contract. All Butler had to do was sign.
“I pulled it up and started looking at the contract,” Butler told the Observer. “It was terrible. It would have hurt this hospital a lot.” The document proposed slashing the reimbursements that Blue Cross, the hospital’s biggest source of revenue, would pay for patient services such as outpatient clinic visits and emergency room care.
As much as 80 percent of charges at rural hospitals are reimbursed through private payers like Blue Cross Blue Shield, compared to the 20 or 30 percent that Medicaid covers. In Iraan, the local school district — one of the biggest employers in the area — and the hospital itself insures its employees through Blue Cross.
Read more: https://www.texasobserver.org/struggling-rural-hospitals-say-theyre-being-preyed-upon-by-blue-cross-blue-shield/
= new reply since forum marked as read
