Competition between Baylor Scott & White Health and Ascension Providence, two major health care providers in Waco, may have intensified.
Ascension Providence will end its contract with Baylor Scott & White’s Scott & White Health Plan effective Sept. 1. Customers who have health insurance through the plan will lose their in-network status at Ascension Providence health facilities that day, according to a statement that the plan is sending some of its 220,000 members in Texas.
“Terminating providers are: Providence Health Center, DePaul Center providers, Providence Health Alliance providers and Waco Internal Medicine Associates,” according to the statement.
Ascension Providence recently became the official name of the former Providence Healthcare Network, which has roots in Waco going back more than a century. Providence long has fallen under the umbrella of Ascension, a Catholic nonprofit health system operating 2,500 care sites and 151 hospitals around the country.
“If you are currently under the care of one of these providers, you may continue care at the in-network benefit level through Aug. 31, 2019. Any care or procedures/surgeries scheduled on or after Sept. 1, 2019, will be considered out-of-network,” according to Scott & White Health Plan’s statement. “Certain exceptions may be made for acute medical conditions such as pregnancy, newly diagnosed or relapsed cancer, active treatment of acute conditions, and active hospital confinements.”
The split with Scott & White Health Plan applies only to Ascension Providence providers, not to other Ascension providers, Ascension Providence spokeswoman Danielle Hall said. In Texas, Ascension also operates Ascension Seton, which includes Dell Children’s Medical Center and Dell Seton Medical Center in Austin.
“We will continue to be part of the provider panel for all the other major health plans and will work with our patients to ensure continuity of care, regardless of their decision,” Hall wrote in an email response to questions. “We know the individuals we serve have many options for their health and wellness needs, and we want to continue to offer Waco and the surrounding communities access to an integrated group of medical providers who can best meet individuals’ health needs.”
Ascension Providence cited “their organization’s access and growth strategies for the future” in making the decision, according to Scott & White Health Plan’s statement.
When Baylor Scott & White Health learned of Ascension Providence’s plans to drop the contract, “we began working immediately in an effort to make this a smooth transition for our members affected by this network change,” spokeswoman Julie Smith wrote in an email response to questions.
Baylor Scott & White Health has “dedicated customer service advocates standing by to assist with transition of care requests,” she said. “With more than 1,000 care sites in the area, including Baylor Scott & White Medical Center — Hillcrest in Waco and multiple hospitals in surrounding communities, Scott & White Health Plan remains committed to offering health insurance products that include providers throughout the region.”
Executives with Ascension Providence and Baylor Scott & White Health did not return calls seeking comment Wednesday.
Scott & White Health Plan has 220,000 members in 80 counties in Central, West and North Texas, according to information on its website. It also bought Austin-based FirstCare Health Plans, with a presence in 143 counties, most in West Texas. The buyout became effective Jan. 1.
Combined, the two plans have 400,000 members, according to the website.
The break with Scott & White Health Plan comes as Ascension Texas CEO Craig Cordola prepares to take the role of COO of Ascension, overseeing all operations effective July 1, according to a press release distributed Tuesday. Cordola previously served as president and CEO of Ascension operations in Waco and Austin, according to the press release.
Nancy McEachern, business development director at Waco-based Insurors of Texas, which specializes in insurance plans for businesses, said she had heard about the decision by Ascension Providence to break with Scott & White Health Plan. She said the plan is among several options her clients choose.
“We deal with many providers, Scott & White being one of them,” McEachern said. “We have respect for both health care systems. Clients come to us, we sit down with them, get to know them and help choose the plan that best suits the needs of their employees. Our goal is to be an advocate for our customers. We believe we have two amazing health care providers in Waco.”