The Texas Association of Health Plans supports HB 2802 and SB 1127 to expand the of use texting in…

Beginning January 28, Texans enrolled in Medicaid started receiving notice from HHSC informing them of the Medicaid unwinding. The end of continuous Medicaid coverage means millions of Texans who have not had to reapply for Medicaid in the last three years will have to go through the process soon. Members who have not signed up for alerts on YourTexasBenefits.com will receive a letter in the mail.

📲 State agencies and managed care organizations can now text Medicaid beneficiaries who provide their phone numbers anywhere on their…

88% of Texas voters say it’s important to have a strong, sustainable Medicaid program according to a new Morning Consult poll. Why it matters: Texas Medicaid provides coverage…

Today’s Texas Medicaid is more than health care coverage—it connects Texans to the personalized care and support they need to stay healthy and live the fullest lives possible. Medicaid managed care gives Texans with complex medical needs access to caring health plan nurses that provide one-on-one support and walk families through every step of the complicated and overwhelming health care system.

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. 

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.

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.

Did you know National Nurses Week is now Nurses Month? Extended in 2020 to recognize the extraordinary efforts of nurses during the early days of the pandemic, the American Nurses Association adopted the evergreen theme “Nurses Make a Difference.” At TAHP, we want to acknowledge the positive impact Medicaid managed care nurses have on the lives of their patients.

By Jessica Lynch As the public health emergency winds down, millions risk losing Medicaid coverage, not because they no…

By: Jessica Lynch and Alicia Pierce In an essay in the New York Times, health care expert Elisabeth Rosenthal…

February 11, 2022 Jamie Dudensing Today, the Texas Association of Health Plans formally announced that Jessica Lynch will join…

Experts agree that as much as 80% of a person’s health is determined by factors outside of direct medical care, including where they are born, grow, live, and work. To encourage better outcomes, health plans are working in communities to help address social barriers to good health, including the need for access to reliable and affordable transportation.

The third special session of the Texas Legislature wrapped up this morning shortly after midnight. This morning, the Legislature voted for the final passage of SB 8, which came out of conference yesterday and appropriates $16 billion in federal COVID relief funds from the American Rescue Plan Act (ARPA).

In the summer of 1965, President and Texan Lyndon Johnson signed the law that would put Medicaid into effect. Fifty-six years later, Medicaid is an essential program for the health of many Americans. In Texas, Medicaid connects more than 4 million Texans with the greatest medical needs to health care and coverage.

Today, the Texas Association of Health Plans released its agenda for the upcoming Texas Covered Conference + Expo, which will be held November 8-10 in Austin, Texas.

A recent external study showed that Texas’ STAR Kids program beats national benchmarks in the majority of areas. These areas include getting needed care (66% compared to 61%), positive customer experience (76% to 68%), specialist rating (82% to 74%) and access to prescription medications (75% to 69%).

June 7, 2021 One week ago today, the 87th Texas Legislature completed the regular session. This Medicaid Monday we’re…

May 24, 2021 The managed care model has transformed Texas Medicaid from a disjointed, ineffective system to a more…

In the last decade, Medicaid managed care transformed Texas Medicaid into a more efficient and effective system that helps Texans live healthy and full lives. The COVID-19 crisis has highlighted how managed care can respond to patient and community needs beyond what is available through a fee-for-service model.

Today’s Texas Medicaid health plans provide more than health care coverage—they connect Texans to the personalized care and support they need to stay healthy and live their lives to the fullest. Texas Medicaid health plans also provide services that go beyond the walls of a doctor’s office, including helping with transportation, coordinating meals, helping with housing and navigating challenges at school and work.

Today’s Texas Medicaid is more than health care coverage—it connects Texans to the personalized care and support they need to stay healthy and live the fullest lives possible while creating efficiencies that benefit everyone.‍

Over the past 20 years, Texas has transformed an outdated Medicaid system that provided fragmented care into a modern, patient-centered health insurance program providing more than 4 million Texans with the coverage and care they need.

Texas taxpayers and patients. Drug costs had almost doubled from 2001 to 2011, and patients received fragmented care that didn’t produce the most efficient or effective results.

The COVID-19 crisis poses unprecedented challenges to Texas and our nation, touching every facet of American life. In the face of these challenges, Texas health insurance providers, Medicaid managed care plans, and Medicare Advantage plans are taking decisive actions to help patients and curb the spread of the virus,

Access to care is an essential part of any health care delivery system, and the Texas Medicaid program is no exception. Like private health insurance, Texas Medicaid managed care organizations (MCOs) establish a network of providers to connect Texans to the personalized care and support they need to stay healthy and live the fullest lives possible. As a result, Medicaid managed care allows Texans on Medicaid to access and choose from a variety of doctors and hospitals in their area.

throughout the COVID-19 crisis, Texas health plans and Medicaid health plans have expanded access to care by encouraging and expanding telehealth services and waiving cost sharing, helping Texans receive the care they need from the safety of their homes. The crisis brought with it an explosion in the use of telehealth across Texas—regardless of patient age and type of health insurance. So far, telehealth appears to be fulfilling its promise as a significant part of the health care system.

The COVID-19 crisis reminds us of the value of affordable health insurance coverage and the peace of mind it brings to Texans and their families. Medicaid managed care has played a key role in helping provide coverage during this economic and health care crisis. Texas Medicaid managed care plans cover medical expenses, coordinate complex medical care, and help Texans stay as healthy and active as possible—all while providing caring, compassionate one-on-one support. The focus on prevention, wellness, and care coordination—getting Texans the care they need to get healthy, stay healthy, and live in their communities—has translated into better care and lower costs. As a result, millions of Texans—including children and pregnant moms—have seen improved outcomes and Texas taxpayers have saved over $5 billion.

The COVID-19 pandemic poses unprecedented challenges for Texas and our nation, touching every facet of American life. During this crisis and into the future, Medicaid Managed Care Plans are connecting Texans to the personalized care and support they need to stay healthy and live their lives to the fullest. Learn more about how Texas Medicaid Managed Care Plans are responding to COVID-19.

oday on Veteran’s Day, we honor all those who served our country. We celebrate and honor America’s veterans for their patriotism, love for our country, and willingness to serve and sacrifice for the common good. 

touching every facet of American life. During this crisis, Managed Care Plans are connecting Texans to the personalized care and support they need to stay safe and healthy and to live their lives to the fullest.

The COVID-19 pandemic is highlighting the importance of health coverage when it comes to financially protecting Texas families from our state’s high health care costs. Texas already had the highest percent of uninsured residents  and some of the highest health care prices in the country—now, both of those problems have been exacerbated by the coronavirus.

A group of health sector stakeholders has launched a new learning collaborative designed to help Texas Medicaid health insurance plans develop and implement strategies to address the non-medical, root causes of poor health for patients across the state. The 12-month project will focus on access to healthy food, housing conditions, transportation, and other social factors that often have a direct impact on a person’s health.

Too often, government programs make headlines due to inefficiencies and cost overruns. But what if the state could adopt a program with a decades-long track record of containing health care cost growth to rates four times lower than national averages, while improving clients’ quality of care? While that may sound too good to be true, Texas was one of the first states to embrace this initiative, known as Medicaid managed care.

On behalf of all major commercial and public health plans operating in Texas, including all plans that manage the Children’s Health Insurance Program (CHIP), the Texas Association of Health Plans (TAHP) is writing you today to strongly urge you to work with your colleagues to pass legislation reauthorizing CHIP—or risk 380,000 Texas children losing their health care coverage. Now six weeks since the missed October 1 deadline, funds that states—including Texas—are using to keep CHIP afloat will soon expire, threatening this life-saving program for one of our country’s most vulnerable populations

The Texas Association of Health Plans (TAHP), the statewide trade association representing commercial and public health plans operating in Texas, including all Medicaid managed care organizations that manage the Children’s Health Insurance Program (CHIP), today issued the following statement urging Congress to act immediately to reauthorize CHIP or risk 380,000 Texas children losing their health care coverage. As of Oct. 1, Congress allowed CHIP to expire by failing to reauthorize funding for the program by the Sept. 30 deadline. CHIP provides low-cost health coverage to roughly 9 million children across the country.  

HHSC has released the Fact Book for 2017, which provides overview of Medicaid programs and caseloads and the 11th Edition of Medicaid/CHIP in Perspective (aka The Pink Book). You can view the Pink Book here.

HB 1917 (attached) was filed this week by Raymond, Zerwas, and Four Price. The bill extends the sunset date of the state run VDP Medicaid formulary to 2030. Current statute gives MCOs full control of the formulary in 2018. TAHP is strongly opposed to this bill and has begun making visits to share reasons for opposition. See our one-page legislative guide on the benefits and savings that will be achieved by transitioning the formulary to MCO management here.

.HAC started meeting this week with presentations by the Legislative Budget Board. On Wednesday the LBB provided an overview of Medicaid. Total Medicaid funding in the 2016-17 adjusted base is $26.3 billion GR and $64.6 billion in AF. This includes an estimated $1.2 billion in GR funds above the 2016-17 Budget to complete fiscal year 2017 expenditures, which includes revenue adjustments, transfers, and assumed supplemental funding. House Bill 1, as introduced includes $27.0 billion in GR funds and $65.5 billion AF for Medicaid in 2018-19, which is an increase of $0.7 billion in General Revenue-Related Funds and $1.0 billion AFs. The committee had many questions about Medicaid managed care, capitation rate setting and savings, and STAR Kids. TAHP staff immediately started meeting with offices to educate them on the value of managed care and will continue meetings over the next several weeks.  LBB Recommendations for HB 1 can be found here.