Blue Cross Blue Shield of Texas aims to do more than just pay healthcare bills. The state’s largest health insurer is getting in the provider business. It has goals to lower health costs, improve care and reach out to many Texans who don’t have insurance or medical home.
Texas has ranked consistently as the worst in the nation’s list of uninsured. Last year, over 5 million Texans had no health coverage, almost 2.2 million more than runner-up California.
Dr. Dan McCoy, president of Blue Cross Blue Shield of Texas mentioned that there has been a surge in retail clinics nationwide, including in pharmacies, strip centers and other settings. Last year, an estimated 2,800 such clinics operated in the U.S., twice as many as six years earlier.
Over the next several years the number of retail clinics nationwide could double as mentioned by real estate firm JLL. The firm also mentioned in a 2019 report that the cost of care is lower and many are more convenient. Yet they accounted for just 2% of primary care encounters.
Blue Cross is taking on two tough issues: The uninsured and the high price of treatment.
The clinics will stress on value-based care, which reimburses providers for keeping patients healthy, not for doing more services.
Infact, Texas has a booming population and a shortage of providers. Only 1 in 4 Texans said they had no place to go when they are unwell except for the emergency room, according to a 2018 survey. More than half of the uninsured population said they had no medical home.
Many families, even with insurance, struggle with health costs, over a half of Texans skip treatment because of the price. So, Blue Cross will offer health plans with Sanitas that have no deductibles and copayments, and they hope to sign-up thousands during the open enrollment on HealthCare.gov.