BCBSTXBlue Cross/Blue Shield of Texas
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Following closing upon meeting all regulatory requirements, Tenet Healthcare and BCBSTX will continue to build on their strong history and long-term relationship to service BCBSTX members with highly coordinated, cost-effective, quality care.
Under the terms of the multi-year agreement, patients with BCBSTX health insurance will be provided with uninterrupted in-network access to Tenet's hospitals, employed physicians and outpatient centres in the state.
This agreement includes all of BCBSTX's commercial and traditional PPO and HMO products.
2011), variations across Texas in total spending and inpatient utilization were found to be similar in BCBSTX and Medicare both in level and in direction.
This study expands previous work by using newly available and more detailed claims data to measure market-level prices, utilization, and health risk among the BCBSTX privately insured population in Texas.
For each hospital referral region (HRR) in Texas, we measure spending per person among BCBSTX enrollees and among Medicare fee-for-service beneficiaries.
The principal data source was claims data on 3,829,083 BCBSTX members, all the BCBSTX members residing in Texas in 2011, or approximately one third of all commercial sector enrollments in Texas.
The BCBSTX data come from four files: claims, enrollment, physician, and pharmacy.
We created two BCBSTX spending measures, one that excludes prescription drugs and another that includes prescription drugs.
Health status for the BCBSTX population was computed at the patient level using the Adjusted Clinical Groups (ACG) scores.
Using the BCBSTX data, we computed a spending index for each HRR and decomposed it into a price index and a quantity (utilization) index.
The ACO is a partnership between BCBSTX and Tenet's clinically integrated organisations in Texas, with the goal of improving the long-term health and wellbeing of BCBSTX members.