WELCOME TO 2021 / COVID 19 & 2020 PAYER UPDATE

2020 has been a year unlike any other that I can recall. While we still face some near-term difficulty, it does appear that the ongoing roll out of vaccines will lead us ultimately to a return to “normal” later in 2021. To keep our membership informed about key developments, we wanted to send a brief update to everyone. Please feel free to reach out anytime to our Advisory Services Group (John/Cheryl/Brenda) or me directly.

What is Advisory Services?

Advisory Services is the recently renamed Provider Relations team. Based on our aggressive move into Value Based Care operations, it was necessary to re-orient this team’s efforts to focus on servicing current member needs, attracting new members, claims resolution and clinical integration/care improvement. Advisory Services and our Clinical Team will be working in coordination to continue our successful efforts with BCBSTX, United Healthcare and Cigna. We are also excited about the new opportunity with Aetna Medical Neighborhood that will be starting in earnest in 2021.

Healthcare Highways

Many of you may have received a recent notification from Healthcare Highways regarding their intention to not participate in Medicare Advantage in 2021. Their exchange product is active and we are looking forward to continuing our efforts on that front. Healthcare Highways has assured us that they are planning to reenter this market in 2022 so stay tuned for updates regarding potential participation.

BCBSTX

Negotiations are continuing with Blue Cross Blue Shield regarding participation in Medicare Advantage. Our legal counsel is currently reviewing the agreement and we are hopeful we will be able to bring it to our membership for consideration, based on their individual business considerations, early in 2021.

In addition, the 2021 Blue Cross PBR program will be kicking off in February 2021. Stay tuned for updates from our Advisory Services team regarding steps we can all take to ensure we achieve the performance objectives outlined in the agreement.

COVID 19 VACCINE NEWS

To our Collin-Fannin County Medical Society members: While we wait to hear more about efforts to bring a Covid vaccine to you and your staff through collaborative efforts with Kroger/Tom Thumb/Albertson’s and Brookshire Grocery store pharmacies and the state’s Expert Vaccine Allocation Panel (EVAP), we’d like to bring to your attention a possible interim solution brought to you by the Wylie Fire Department.
Wylie, TX Covid-19 Vaccination Request Form.

To access this form, please visit:

https://docs.google.com/forms/d/e/1FAIpQLSd4KPOCtrib692RtOC8NWZe2rEhJNv0GQad5SoYPtQOCCkruQ/viewform

Happy New Year and Best Wishes on a Prosperous 2021!
William Scott Hurst MBA, FACHE