ERS Chooses United HealthCare Over Blue Cross – Does UHC Have Better Provider Pricing?

More than 400,000 state employees, retirees, and their dependents will get a new health insurance company. The Employees Retirement System (ERS) is negotiating a new contract with UnitedHealthcare Services, replacing Blue Cross and Blue Shield of Texas as the party administrator for the self-funded HealthSelect of Texas health plan.

ERS officials say the new contract will save $41 million and that they chose United because of its “winning combination of programs, services, and low administrative fee.”

They added they expect minimal network disruption and project that about 2 percent of HealthSelect members might switch their primary care physician.

TMA’s Payment Advocacy Department advises physicians that because a new carrier will administer the ERS business, they may want to reevaluate their payer mix. Be aware that United has secondary networks and consider those agreements when evaluating the practice’s payer mix.

Blue Cross filed a protest with ERS in March 5 and asked for a review of the competitive bidding process ERS used. Blue Cross contends switching to United will cost the state an additional $450 million because Blue Cross offers better discounts to members of the state plan than does United, and it has a larger network of physicians, hospitals, and other health care professionals.

“Because of our experience with ERS and its participants, providers, and others over the last three decades, we are deeply concerned with the impact ERS’ decision will have on the state of Texas and ERS participants,” a Blue Cross statement said.

Editor’s Note: Does UHC have better pricing than does BCBS? One would think so with a group this large electing to go with the best bid. BCBS representatives are trained to tout “our discounts are better than theirs”, which may be true. But a 50% discount off $100 is not as good as a 45% discount off $80.