Leadership by Fire: Stephanie Stephens New Texas Medicaid, CHIP Director
By Joey Berlin Texas Medicine August 2020


Stephanie Stephens received a not-so-welcome gift entering her new job running Medicaid operations for the nation’s second-largest state: A global pandemic.

In that sense, the universe wasn’t easy on Ms. Stephens, the new director of Medicaid and CHIP for the Texas Health and Human Services Commission (HHSC).

“The first several weeks have been a balancing act,” Ms. Stephens said in written responses to questions from Texas Medicine in June, noting that HHSC had to respond to COVID-19 while continuing its usual day-to-day operations and planned improvements.

But at least she had the expertise. Ms. Stephens already had more than a decade of experience within HHSC’s walls when she succeeded Stephanie Muth, who retired on May 1.

Previously HHSC’s deputy Medicaid director, Ms. Stephens has been with HHSC since 2008, when she joined the agency as a policy analyst. Prior to that, she was a health and human services budget analyst at the Texas Legislative Budget Board.

“I feel fortunate to take on this role after serving as deputy director. The path charted by … Stephanie Muth is a strong guide,” she said.

Her to-do list includes improving HHSC’s oversight and advancing value-based care in the agency’s programs.

“We can’t do these things alone. It takes partnership among all of us – the people who rely on us for services, our health plans, our providers, along with the support we get from the Office of the Governor, Texas legislators, and our federal partners,” Ms. Stephens said.”

The Austin native traces her interest in health care to her college days, when she worked in an intensive treatment program for children with severe attention deficit and hyperactivity disorder combined with other behavioral and developmental disorders.

“I saw how these conditions affected the children’s lives and their families, and the impact of the children receiving effective treatment and services. This experience sparked my interest in health care and my specific skills led me to policy,” she said. “I would not have made it to Medicaid director without the mentorship I received along the way. I’ve worked for a number of state Medicaid directors and have watched and learned from their inspiring yet distinct leadership styles.”

Although she notes state agencies in Texas have responded to plenty of natural disasters and public health emergencies, COVID-19 has required Ms. Stephens and HHSC to create a new rulebook as they go.

“In the beginning, we pulled out past response plans for guidance,” she said, “and quickly recognized this public health emergency is unprecedented.”

She said the agency continually reassessed its response to the pandemic. At the same time, HHSC provided “significant flexibilities” to help patients and practitioners, including covering COVID-19 testing without prior authorization and allowing extensive telemedicine use.

“When the time is right, we will look back on our efforts to identify what we can do better, despite hoping we never encounter anything like this again,” Ms. Stephens said.

The pandemic, and its effect on the Medicaid and CHIP population, is far from the only pressing concern HHSC has faced during Ms. Stephens’ early months on the job. Recent dips in vaccination rates are also on her radar, as is enhancing oversight of Medicaid managed care organizations (MCOs).

“Our team is actively communicating with the Department of State Health Services to develop messaging for members around the importance of check-ups and immunizations,” Ms. Stephens said. “We are exploring opportunities in collaboration with our MCOs and providers on the front lines to develop immunization clinics that are safe and convenient for the Texans we serve. We are also tracking data, as certain immunization measures play a key role for some of our quality programs.”

She also highlighted the importance of collecting input from and providing feedback and timely information to stakeholder organizations like the Texas Medical Association.

“It’s the only way we can prioritize our focus for improvement and be more innovative in the Texas Medicaid program,” she said. “In this role, I plan to focus on a more deliberate approach in how we communicate with stakeholders across our various initiatives. We need to be clear and consistent.”

Tex Med. 2020;116(8):12-13
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Last Updated On

August 03, 2020

Originally Published On

July 28, 2020

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