Physicians are the heart and soul of healthcare. We tell our members their primary care physician should be their first stop for questions regarding their health. As the old saying goes, “The doctor knows best.”
We also believe that responsibility comes with accountability. Doctors must be accountable for the health and health care expenses of the communities they serve. That’s why we’ve placed doctors in leadership positions at Blue Cross and Blue Shield of Texas (BCBSTX). In fact, our state president and each of our market presidents is a physician.
Physicians Understand our Members—and the Provider Community
Most doctors believe their top priority is to deliver quality care to patients. We do too. Our goal is to give our members access to high-quality, cost-effective health care. Our physician leaders are uniquely positioned to accomplish our goals and address the challenges of the health insurance industry.
“I can’t help but approach every health care decision from a physician’s perspective,” said Southeast Texas Market President, Bob Morrow, M.D. “Whether I’m conducting a check-up with a patient in my office or considering the health of Blue Cross’ entire membership, I want to do everything in my power to make sure they’re okay.”
Doctors, hospitals and clinics, or “providers,” are BCBSTX’s integral partners in a complex environment. More than any other health insurer, we understand their perspectives because our physician leaders have stood in their shoes. Our market presidents have personally treated patients and managed the business side of providing care. As a result, they can empathize with our providers as they make important business decisions.
“We understand the support and the burden that our decisions can have on our providers,” said North Texas Market President, Paul Hain, M.D. “That influences their ability to care for our members so we consider every decision carefully.”
“It's exciting because it allows us to find ways to really improve the existing system with an understanding of how the system actually works,” added Morrow.
Physicians are Suited Well to Lead our Business
Changing healthcare in Texas takes unique perspective, clear direction and transformational leadership. Our physician leaders are well-positioned in these three areas because they have an understanding of both the provider and the insurance side of the healthcare system.
“I think physicians have a lot to contribute, not only to the overall voice of medicine, but also in the areas of health care economics, patient-centered care and public policy, to name just a few,” said BCBSTX Chief Medical Officer and Southwest Texas Market President, Esteban López, M.D.
BCBSTX physician leaders use their experience to make decisions that help finance health care and manage the complicated transactions that occur between patients and their health care providers.
“We serve as a steward of our members’ health care coverage dollars and function as an advocate for those members, when negotiating contract rates with providers that they would likely not have by themselves,” López said.
What is the Role of a Health Insurance Company in Today’s Health Care Environment?
In addition to offering coverage, we believe health insurers should play a critical role in holding the provider community accountable for the services they provide. Doctors shouldn’t get a check in the mail simply for checking a box and completing a service. We expect them to make a positive impact on the health of their patients, our members. We understand that people want more value for the price. That’s why BCBSTX is championing the change to value-based care in our state. But this evolution won’t be easy. It will take all parts of the health care system—payer, provider and member—working together to achieve the common goal of affordable, high-quality care.
“I would argue physicians always want to do what’s best for their patients,” McCoy said. “It’s really about connecting the dots and properly financing and compensating that service.”
While today’s health care environment is challenging, uncertain and constantly evolving, it also provides an opportunity for remarkable change. With physician leadership in place, BCBSTX is well-suited to be a leader in the innovative transformation of the health care system in Texas and beyond.
“We have the right nexus of technology, process, spirit and a compelling case for change,” McCoy said. “Our present environment is unsustainable, which I think is generating the type of new ideas and decisions that will help improve our products and value delivered to the patients and members we serve.”
Meet BCBSTX’s physician leadership:
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