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…
Covered Conference + Expo that will take place in person in Austin (COVID permitting) from November 8-10. The conference is the largest event of its kind in Texas and brings together decision-makers from across the health care spectrum—from major health plans, providers, and regulators, to legislators, journalists, academics, and more.
Download PDFJune 7, 2021 One week ago today, the 87th Texas Legislature completed the regular session. This Medicaid Monday we’re looking at some of the changes Texas made to Medicaid and how they will build on the success of the managed care model. While both HB 133 and HB 2658 have passed the Legislature, neither…
A recent survey of small business owners provides a warning for policy makers. Nearly one in three small business owners that provide health coverage to employees has considered dropping it—the vast majority because costs are too high.
Download PDFMay 24, 2021 The managed care model has transformed Texas Medicaid from a disjointed, ineffective system to a more comprehensive, streamlined system that provides better care with better results and costs taxpayers less. Like any system, managed care can be updated and refined to better serve patients. Even small, simple steps can make a…
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.