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.
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.
Can driving just a few miles save a patient thousands of dollars? If they’re in the market for health care, the answer is yes. In Dallas, according to a recent article in D Magazine, the cost of a gallbladder removal surgery can range from $5,000 to $35,000. And rarely are prices posted online—even though they’re supposed to be.
Download PDFBy Jessica Lynch As the public health emergency winds down, millions risk losing Medicaid coverage, not because they no longer qualify but because they get caught in the redetermination process once continuous coverage ends. However, one population faces continual risk for interrupted coverage — pregnant Texas women. When a member loses their Medicaid benefits…
Download PDFby Jamie Dudensing and Alicia Pierce A recently announced change to the administration of the Affordable Care Act will expand access to affordable health insurance for an estimated 5 million Americans. In Texas, it could provide options for more than 600,000 of the state’s uninsured. Currently, individuals qualify for subsidies even if they have…
Health plans focus not just on the health of individual members, they also invest in the health of communities. By helping to build strong communities, health plans support better health outcomes for everyone. Since the beginning stages of the pandemic, Superior HealthPlan has worked with more than 70 schools and organizations in Texas to launch and fund hygiene closets for lower-income neighborhoods. Grants to the community-based organizations hosting the closets help organizations meet people’s basic needs and create community connection.
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.
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.
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.
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.
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.