Have You Ever Been A Child And Been Told No?

Within 24 hours of posting a link to a copy of Texas A&M’s BCBS ASO Agreement it has been removed from the internet. The Cone of Silence continues………………..

Did You Read The Contract? Then Why Did You Sign It?

Texas A&M University’s group health plan is administered by Blue Cross of Texas. A review of their partially redacted ASO Agreement is an interesting read.

Back in 2005 a BCBS regional sales manager started touting BCBS discounts as a main selling point in competitive settings. “Our discounts are the best in the industry and no one else comes close” was the message he instructed his sales people to push across Texas. “Give us a sample of claims and we will reprice to prove it!” seemed convincing to most plan sponsors. This practice was picked up by consultants as a sure fire way to determine who had the best discounts. The re-pricing game was effectively established as the litmus test and it’s still in use today by legacy consultants.

But not all re-pricing exercises proved BCBS the best. A consultant for a large South Texas employer concluded HealthSmart had the best discounts. A subsequent consultant for the same group concluded Mutual of Omaha had the best discounts. A third subsequent consultant concluded BCBS had the best discount.

I thought there must be a better way to determine truth from fiction. What better way to do that than to review actual provider contracts? So the journey began to do just that.

“Bill, you will never get your hands on a BCBS hospital contract!” said my contact at BCBS. “Bill, forget it! I can’t share my BCBS contract with anyone” said a hospital administrator friend. “Give it up Bill, you will never succeed” was the message from everyone I approached.

As a kid, were you ever told you couldn’t have something? You damn sure were going to by hook or crook. I spent the next 8 months doing everything I could to get my hands of various provider contracts.

And I did.

In my mailbox one day I found an envelope postmarked from Chicago. Inside was a BCBS hospital contract! I later found out who sent it and how it was obtained. My filing cabinet was filling up with provider contracts.

A reporter for a national publication called and asked if I would be willing to share them. So I did. She is now a former reporter devoted to exposing the truth about what things cost in healthcare. Her microphone is big and loud and she is making a difference.

So the point of this is Nothing Is Secret Forever. Have you ever been a child and been told no?