Blue Cross Blue Shield of Texas is expanding its Medicare Advantage coverage for 2024, entering 80 additional counties in the state.
Beginning in 2024, BCBSTX's Medicare Advantage plan will reach 6.3 million Medicare-eligible Texans in 227 of 254 counties, according to a Nov. 29 press release.
The plan provides access to nearly 30,000 primary care providers, 148,000 specialists and 4,600 hospitals and care facilities.
Texas currently has the third most ASCs of any state in the nation, with 458. A number of healthcare facilities, including ASCs, have made the decision to cut ties with Medicare Advantage plans in the last year, citing low reimbursement rates and high rates of denial for necessary patient procedures.
"Many of the Medicare Advantage plans in our market are trying to pay below the Medicare physician fee schedule, and none of them are accounting for the implant costs associated with doing surgery in our ASC. I am also looking for steerage from the payers for ASC strategies in our market. As the low cost/high value provider in the market, we should see significant streerage to our facility but have not experienced that yet," Andrew Lovewell, CEO of Columbia (Mo.) Orthopaedic Group, told Becker's.