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June 27, 2022

Medicaid Monday: Mental Health Innovations in Managed Care

In 2021, 34.2% of adults in Texas reported symptoms of anxiety and/or depression. Experiencing mental health challenges can have long-lasting consequences, especially for vulnerable populations. Every Texan deserves access to mental health services. Today’s Texas Medicaid managed care organizations provide a broad spectrum of screenings and treatment services for mental health conditions and substance use disorders with timely access for members and appropriate follow-up care. Managed care allows for flexibility in developing new models of service delivery that are not possible in traditional fee-for-service. 

June 16, 2022

Value of Coverage: Mental Health

People with health insurance have better access to care, and importantly that includes mental health care. Two recent studies show that people with insurance not only have better access to mental health services, but they are overwhelmingly satisfied with the services they receive.

June 13, 2022

Medicaid Monday: Managed Care Means Innovation

In Texas, the 1115 Medicaid Transformation Waiver allows the state to expand managed care, which allows for innovations not permitted in traditional fee-for-service Medicaid. Since the inception of managed care, ensuring high-quality care for members has been the work of managed care organizations. Here are some ways Texas managed care health plans go beyond the walls of a doctor’s office to increase community access to services, reduce unnecessary hospitalizations, and improve the quality of members’ lives.

June 7, 2022

Now is the time for Texas to look for ways to reduce Big Pharma’s big prices

At $15.3 billion annually, Texans spend more on prescription drugs than any other state in the country. Big Pharma continues to raise prices, making lots of prescription drugs unaffordable. During the COVID pandemic alone, Big Pharma raised prices on 832 drugs. Patients are taking to Twitter to express outrage and shock at the rising price of the sometimes life-saving medicine they need.

May 26, 2022

The No Surprises Act is Working, Texas Can Learn from the New Law

Today it was announced that since the No Surprises Act went into effect at the beginning of the year, Americans haveavoided more than 2 million surprise bills. The law protects patients from most surprise medical bills and removes them from the middle of negotiations between providers and insurers when it comes to disputes on what should be paid. That’s the good news.

May 23, 2022

Medicaid Monday: Managed Care Reduces ER Visits

The use of emergency rooms for primary care services is decreasing, thanks to Medicaid managed care. A recent report by the Texas Health and Human Services Commission (HHSC) shows a 15.5% decrease in the number of potentially preventable emergency room visits in Texas Medicaid and CHIP programs. This is great news for both Medicaid members and taxpayers. Utilizing preventative and standard care before conditions become emergencies leads to better health outcomes and to less costly care.

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