Baylor Scott & White Health Plan is exiting the Texas Medicaid managed care market by the end of August and will no longer offer individual marketplace plans past 2026.
The insurer, part of the Dallas-based health system, administers Medicaid benefits to about 125,000 enrollees, and it provides marketplace coverage to about 100,000 people. The market exits will also result in the elimination of 321 jobs statewide, according to the Dallas Morning News.
Baylor Scott & White Health CEO Pete McCanna told Becker’s April 15 the system will continue to provide care to the affected patients.
“We’re exiting providing health insurance to those patients in those geographies, but we will still be a primary provider for many of them, particularly in Central Texas, and they will continue to have access to insurance — it’s just our organization will not be delivering it,” he said.
He said the system’s model — which emphasizes a wide array of services delivered 24/7, on demand — is more effective in populations with more stable coverage, such as Medicare Advantage and direct-to-employer plans.
“That model can work both for the customer and economically because there’s not as much turnover in those populations. It’s harder to do in marketplace and Medicaid because there’s high turnover,” Mr. McCanna said.
He also pointed to the state’s Medicaid procurement process, noting Baylor Scott & White was not selected in certain regions.
“We weren’t going to be in a position where we could provide the insurance and be the provider of care,” he said.
The health plan will continue to offer employer group and Medicare Advantage plans, while the health system will continue to accept Medicaid and ACA plans from other insurers.
“We are committed to supporting affected team members through this transition with new and unique resources that include dedicated career guidance, priority access to open roles in our system, funded reskilling for high-demand clinical positions, relocation reimbursements and extended medical benefits to help support continuity of coverage,” a spokesperson for the health system said.
At the Becker's 5th Annual Fall Payer Issues Roundtable, taking place November 2–3 in Chicago, payer executives and healthcare leaders will come together to discuss value-based care, regulatory changes, cost management strategies and innovations shaping the future of payer-provider collaboration. Apply for complimentary registration now.