Health & Science

Blue Cross And Blue Shield Of Texas Wants Clinics To Do Things Differently, So It’s Opening Its Own

One of the state’s largest insurers is making a play as a care provider, with plans to open six clinics in the Houston-area.

Blue Cross and Blue Shield of Texas plans to open 10 of its own clinics in the Houston and Dallas areas, a plan that highlights an emerging method of cost-cutting for insurers. 

The medical centers will be operated by Sanitas USA, a clinic operator that began in Colombia as an insurer itself. Sanitas has previously opened clinics in New Jersey and Florida with Blue Cross and Blue Shield (BCBS) plans in those states as partners. The Texas clinics are planned to open in January 2020.

BCBS executives say the move is part of the company’s “value-based journey.” Care providers will be reimbursed based on patient outcomes rather than the traditional fee-for-service model, a framework BCBS says results in more holistic family-based care and lower costs.

Each clinic will provide primary-care services alongside urgent care, lab work, diagnostic imaging, care coordination, and wellness and disease management programs, according to a news release from the company. 

“This kind of model of care is really more or less the way I was trained to be as a family doc,” said Bob Morrow, Southeast Texas Market President of Blue Cross and Blue Shield of Texas. “When you go from more of a fee-for-service based to a fee-for-value based, this actually allows me to do what I do as a family doctor better and be rewarded for it.” 

The move signals a trend towards vertical integration on the part of insurers, who have noticed urgent care clinics rising in popularity, Rice University health economist Vivian Ho told Houston Matters. The abundance of free-standing emergency rooms in Texas, many of which leave patients with high bills for standard services, may have driven the decision, Ho said.

 

The six Houston-area clinics will be located in Bellaire, Katy, Northwest Houston, Southeast Houston, Spring and West Houston, the company announced. Each clinic will service Blue Cross and Blue Shield card holders, self-pay patients and seniors with traditional Medicare coverage.

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