October 23, 2018
Doctors, Insurers, Hospitals Meet to Set Priorities for Strengthening Medicaid Managed Care
--Important Agreement Reached on Reversing Troubling Maternal Health Trends--
AUSTIN—As the future of Texas Medicaid promises to be a central topic of discussion in the 86th Texas Legislature, leaders from three pillars of the Texas health care system gathered in Austin on Oct. 12 for a first-ever summit to identify and commit to working on shared priorities for strengthening the program.
State Rep. Richard Peña Raymond (D-Laredo), chairman of the House Human Services Committee, kicked off the meeting and welcomed the organizations. He applauded the groups for adopting a teamwork approach to finding innovative solutions.
Leaders from the Texas Medical Association (TMA), Texas Hospital Association (THA), the Texas Association of Health Plans (TAHP), and the Texas Association of Community Health Plans (TACHP) unanimously agreed their top priority is ensuring excellent, tailored care for the 4 million Texas Medicaid members they collectively serve. The health care leaders committed to continuing the positive strides Texas has made in adopting better, smarter ways to deliver care, in part by reducing administrative burdens for physicians, health care providers, and health plans.
They seek improvements because Texas Medicaid has long faced criticism for what many call slow and burdensome regulatory processes. Medicaid is the state/federal health insurance program for lower-income Texans and many Texans with disabilities.
Given the troubling trends in maternal health in recent years, and with Medicaid covering more than half of all Texas babies born each year, all four organizations agreed maternal health is a pressing priority. They committed to collaborating on solutions to improve care for Texas mothers — including improving preventative care for women prior to pregnancy, educating women on importance of early prenatal care, improving management of high-risk mothers, and extending post-partum care. Importantly, the leaders agreed the first priority must be ensuring mothers with Medicaid coverage continue to receive that vital coverage for 12 months after giving birth. Currently, the women receive only 60 days of Medicaid coverage after delivery. Recent trends indicate mothers are at risk for severe mental health conditions and other complications — even death — beyond 60 days and they need tailored care for one year post-partum.
Other priorities discussed included reducing red tape and administrative burdens for doctors, providers, hospitals, and health plans to streamline patient care and ensure every Texan with Medicaid is getting the right care at the right time in the right place.
TMA President Douglas W. Curran, MD, said the unusual collaboration by the four groups provides a unique opportunity to better a system so important to Texans and those who serve them.
“Here’s what’s happening: Medicaid’s often senseless leftover regulations have driven too many physicians away from the program, harming patient access,” he said. “But outdated and redundant reporting systems also saddle hospitals and insurers with red tape that have no benefit to patient care. So it is vital that our groups dedicate ourselves to making meaningful progress, together. We can and must do better for our Medicaid patients, because Medicaid is so important to so many people in my community and across our state.”
Jamie Dudensing, CEO of TAHP, and a nurse, said: “We all know someone who relies on Medicaid for their health coverage — whether it’s your neighbor, your friend, your elderly parent, a classmate, or a co-worker. Our important meeting cemented the fact that the health care community as a whole shares the goal of making sure Texas Medicaid’s lasting impact is a positive one that improves health and changes the lives of Texans for the better. When we work together, we can solve common challenges and develop solutions that work for every Texan we serve.”
“A strong Medicaid program is essential for strong hospitals and a strong system of health care across Texas,” said Ted Shaw, THA president and CEO. “Texas hospitals long have partnered with the program not only to deliver the best care to the state’s most vulnerable populations but to finance a large portion of it as well. Texas hospitals look forward to working with our physician and provider partners to build an even stronger, more effective program.”
The four organizations voiced a strong commitment to collaborating in the following areas:
- Modernize the Medicaid Program: Reducing red tape and administrative burdens will lead to more timely and efficient care and encourage more physicians to participate in Medicaid.
- Improve Systems and Processes of Care: Streamlining existing processes that impact the delivery of health care in Medicaid, such as care coordination, will result in increased access for covered Texans, as well as a more efficient system for physicians and hospitals.
- Increase Access to Care: Increasing access to preventative, behavioral, and maternal health care will result in a healthier Texas and reduced costs for taxpayers.
- Strengthen Patient Protections: Texas Medicaid clients should be able to register complaints easily when they feel they are not receiving the quality of care they need, but the current processes are confusing and intimidating. Simplifying and improving these processes will ensure better health care for Texans covered by Medicaid.
The Texas Medical Association is the largest state medical society in the nation, representing more than 51,000 physician and medical student members. It is located in Austin and has 110 component county medical societies around the state. TMA’s key objective since 1853 is to improve the health of all Texans.
Founded in 1930, the Texas Hospital Association is the leadership organization and principal advocate for the state’s hospitals and health care systems. Based in Austin, THA enhances its members’ abilities to improve accessibility, quality and cost-effectiveness of health care for all Texans. One of the largest hospital associations in the country, THA represents 452 of the state’s non-federal general and specialty hospitals and health care systems, which employ some 369,000 health care professionals statewide. Learn more about THA at www.tha.org or follow THA on Twitter at http://twitter.com/texashospitals.
The Texas Association of Health Plans (TAHP) is the statewide trade association representing private health insurers, health maintenance organizations, and other related health care entities operating in Texas. Our members provide health and supplemental benefits to Texans through employer-sponsored coverage, the individual insurance market, and public programs such as Medicare and Medicaid. TAHP advocates for public and private health care solutions that improve the affordability, access, and accountability of health care for many Texans. As the voice for health plans in Texas, TAHP strives to increase public awareness about our members’ services, health care delivery benefits, and contributions to communities across Texas.
Twelve managed care companies established by Texas public and nonprofit regional healthcare systems comprise the membership of the Texas Association of Community Health Plans. Member health plans cover more than two million Texans, and are committed to supporting and improving the health of people living at low to moderate incomes.
TMA Contacts: Brent Annear (512) 370-1381; cell: (512) 656-7320; email: brent.annear[at]texmed[dot]org
Marcus Cooper (512) 370-1382; cell: (512) 650-5336; email: marcus.cooper[at]texmed[dot]org
THA Contact: Lance Lunsford, THA chief marketing officer (512) 298-7371; llunsford[at]tha[dot]org; Twitter: @lancelunsford
TAHP Contact: John Ford, TAHP director of communications (512) 900-3915; cell: (318) 447-8663; jford[at]tahp[dot]org; Twitter: @txhealthplans
TACHP Contact: Kay Ghahremani, TACHP president/CEO; (512) 744-3735; kay.ghahremani[at]tachp[dot]org