Insurance & Benefits

UTSW and AmeriGroup Solve Network Dispute

Advertising works.

Last week, advertisements began to pop up on LinkedIn warning consumers that UT Southwestern and Texas Health Resources were set to leave the network Medicaid and Medicare insurance provider AmeriGroup. The two sides have since come to an agreement.

AmeriGroup’s marketing campaign surfaced the issue: “UT Southwestern Medical Center and Texas Health Resources have chosen to leave AmeriGroup’s network,” the advertisement read. “We continue to fight for our members and what’s right for Texas.”

Almost as soon as the conflict was made public, the two sides came to an agreement.

“We are pleased to have successfully negotiated with AmeriGroup a contract that will ensure the continuity of exceptional care provided through Southwestern Health Resources affiliated physicians,”a UT Southwestern statement read. “We all recognize the importance of providing uninterrupted health care from trusted clinicians at Texas Health Resources and UT Southwestern for vulnerable populations, particularly during this pandemic.”

In 2015, Texas Health Resources and UT Southwestern united to form a joint operating company called Southwestern Health Resources, comprising more than 29 hospitals, 6,000 physicians, more than 650 outpatient facilities across Dallas-Fort Worth. AmeriGroup is a subsidiary of Anthem, and has 851,000 members in Texas. The vast majority of those members are on Medicaid.

Texas Health Resources is no stranger to contract disputes. There have been numerous eleventh hour resolutions with Blue Cross Blue Shield of Texas and Cigna over the past few years. Because no one health system or health insurer has overwhelming dominance in the North Texas market, both providers and insurers have made attempts to sway the public to their side during disputes about pricing and reimbursements. After negotiations have broken down, providers and insurers  begin making public the “misconduct” of the other side. Usually these contract disputes are between health systems and commercial insurers.

This time around, the conflict seems to have been resolved relatively quickly after the advertisements went online. “AmeriGroup Texas is pleased to have concluded our negotiations with Texas Health Resources/UT Southwestern Medical Center, and that our members will continue to have access to their hospitals and physicians,” AmeriGroup said via statement.

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