- Blue Cross Blue Shield of Texas is joining with Colombia-based global healthcare company Sanitas to open 10 primary care medical centers in Dallas and Houston for appointments beginning in January. Blue Cross and Blue Shield cardholders, along with self-pay patients and Medicare fee-for-service beneficiaries will be able to use the facilities.
- The centers will deliver primary care, urgent care, lab and diagnostic imaging services and care coordination, along with wellness services and disease management programs to create a "one-stop medical center" for everyday health needs, according to Keralty Group president Joseba Grajales. Keralty owns Sanitas, which has partnerships with other Blues insurers including Horizon Blue Cross and Blue Shield of New Jersey and Florida Blue.
- All new locations will have expanded hours beyond the usual 9-5, and some will be open year-round.
As value-based care becomes increasingly en vogue, the traditional lines between providers and insurers blur. Payers are looking to have more control over where their beneficiaries receive care in an effort to foster cheaper preventive care, as opposed to costly ER visits farther down the road.
Retail pharmacy behemoth CVS snapped up insurer Aetna in a mammoth deal late last year, and UnitedHealth Group has been purchasing clinics and practices for years through its health services business Optum. Such vertical integration allows the companies greater control of a consumer's overall healthcare journey.
This BCBSTX-Sanitas USA partnership is meant to increase the availability of healthcare services in myriad communities, according to the two companies, and try to rectify the gaps in fragmented care. It's also meant to lower costs.
"We believe that this partnership will advance primary care services and is an effective approach to providing quality health care outcomes, improving member engagement and experience, and lowering costs for our members, including populations that may have difficulty accessing care," BCBSTX President Dan McCoy said in a statement. The plan currently serves about 5 million members.
The Dallas-Fort Worth area has one of the country's highest rates of healthcare spending, according to the Health Care Cost Institute. It also has higher prices for comparable services, ranking 17th on a list of 112 metropolitan areas for prices, making it a good testing ground for value-based, preventive care initiatives like this one.
Sanitas USA already owns and manages clinics in three other states: 23 in Florida, four in New Jersey and three in Connecticut.
BCBSTX, the only statewide, customer-owned payer in Texas, has been on a cost-lowering kick for some time in the state. Its parent company, Chicago-based Health Care Service Corp., also owns Blues plans in Illinois, New Mexico, Montana and Oklahoma, so the potential for scalability with this new deal exists if the rollout goes smoothly.
The initial 10-clinic rollout of the partnership will include six in Harris County (Bellaire, Katy, Northwest Houston, Southeast Houston, Spring and West Houston) and four in Dallas County (Irving, Las Colinas, Mesquite and Richardson).