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Letter to Our Patients


September 26, 2016

Dear Kelsey-Seybold Patient,

On July 1, Kelsey-Seybold received a termination letter from Blue Cross Blue Shield of Texas (Blue Cross) removing us from their PPO/POS and Traditional/Par Plan network effective October 1. This Blue Cross termination of Kelsey-Seybold from their network set in motion a disruption of the care to more than 120,000 of our patients who had come to rely on us for their medical care over the decades we have participated in the Blue Cross network.

The termination letter ended a two year effort by Kelsey-Seybold to offer our accountable care plan to Blue Cross members. The accountable care plan we proposed to Blue Cross has a proven track record of lowering the total cost of medical care by 15 to 30% while raising the quality of care and patient satisfaction for over 70,000 patients and more than 70 employers who have adopted this plan. The Kelsey-Seybold accountable care plan is offered through all of the other major health insurance plans in Houston.

Our understanding of the Blue Cross termination comes from our discussions with them after receiving their letter. We asked to extend the termination date through the end of 2017 to give employers and patients time to make alternate arrangements. Blue Cross would not extend the termination date. They would not agree to continue payment for medical services at the rate they agreed to pay in May 2013. After these final discussions, we knew that Blue Cross would not accept our proposal to offer our accountable care plan and they would simply no longer honor our May 2013 agreement.

Because of the severe disruption to our relationships with the patients who were affected by this termination, we had to immediately prepare for October 1. We have made difficult decisions to manage this impact. Helping our patients who were undergoing active medical treatment transition to other physicians has been most difficult.

We respect the Blue Cross mission, but we now understand that our approach to raising the value and convenience of medical services is not compatible with the Blue Cross plan for their members. We sincerely hope to reunite with our patients who have been affected by this Blue Cross termination through any of the other major health insurance plans in Houston.

Sincerely,

Spencer R. Berthelsen, M.D., F.A.C.P.
Managing Director
Kelsey-Seybold Clinic​
Download a Letter to Our Patients (September 26, 2016)
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