AUSTIN, Texas, Dec. 4, 2018 — Today, officials at FirstCare Health Plans announced the new FirstCare Advantage Dual SNP (HMO SNP) plan, which is back after a brief absence, and available in the Lubbock and Amarillo communities.

The plan is designed to meet the special needs of those with Medicare and Medicaid. They must be eligible for both Medicare and Medicaid in order to enroll in FirstCare Advantage Dual SNP, and they must reside in one of the following Texas counties: Carson, Crosby, Deaf Smith, Floyd, Garza, Hale, Hockley, Hutchinson, Lamb, Lubbock, Lynn, Potter, Randall, Swisher, and/or Terry.

“We are excited to introduce a new plan for 2019—FirstCare Advantage Dual SNP for Medicare beneficiaries with both Medicare and Medicaid,” said FirstCare Assistant Vice President of Government Programs Danielle Jaber. “At FirstCare, we’ve been helping Texans cut through health care confusion for over 30 years. We’re proud to be a part of the communities we serve, and we believe all Texans should have access to affordable, high-quality health care.”

For 2019, beneficiaries will be able to access a number of programs that enhance the care and services covered under the FirstCare Advantage Dual SNP plan. These include assigning dedicated case managers to members who need help accessing care, providing education and support to members who have certain chronic conditions, connecting members to a pharmacist who helps them manage their medicines, accessing telemedicine services via FirstCare Virtual Care—powered by MDLIVE, and providing a free phone service for members that allows them to talk with a nurse about their health concerns—24 hours a day, seven days a week.

Medicare beneficiaries can enroll in FirstCare Advantage Dual SNP during the federally regulated Annual Enrollment Period (AEP) from October 15, to December 7, 2018, with benefits effective January 1, 2019. Certain circumstances allow for enrollment throughout the year, outside of AEP. For more information, prospective members are encouraged to call 1-866-229-4969 (TTY users call 1-800-562-5259), October 1 – March 31, 8 a.m. – 8 p.m. Central Time (CT), daily; April 1 – September 30, 8 a.m. – 8 p.m. CT, Monday – Friday. They can also write to:  FirstCare Advantage Dual SNP (HMO SNP); Attn: Customer Service; 1901 W. Loop 289, Suite 9; Lubbock, Texas 79407. If you speak Spanish, language assistance services are available to you. Si usted habla español, tenemos servicios de asistencia de idiomas disponibles para usted.

FirstCare Advantage Dual SNP (HMO SNP) is a Health plan with a Medicare contract and a contract with the Texas Medicaid program. Enrollment in FirstCare Advantage Dual SNP (HMO SNP) depends on contract renewal.

About FirstCare Health Plans
At FirstCare, our mission is to work together to serve our customers and build healthier communities—one member at a time. Since 1985, we’ve been serving the health care needs of members across North, West, and Central Texas. Today, our service area includes 143 counties, with local offices in Abilene, Amarillo, Lubbock, and corporate offices in Austin, Texas. We offer a wide range of HMO, PPO, HSA, and ASO products through a variety of programs, including small and large employer plans; state, federal and teacher plans; government programs; and the Health Insurance Marketplace. With the support of our owners, Covenant Health in Lubbock and Hendrick Health System in Abilene, we serve over 150,000 members. For more information, please visit FirstCare.com.

Legislators need to back Texas Health and Human Services Commission

By Ken Janda

Have you followed much news coverage of our Texas Health and Human Services Commission ? In the midst of escalating concerns and long-running criticism, some valid and some not, what might surprise you the most is learning the Health and Human Services Commission of the state of Texas runs the best Medicaid operation in the country — despite being a gigantic, wide-ranging organization charged with helping often overlooked poor and frail Texans; despite being underfunded year after year, and despite sometimes serving as a whipping post for policymakers.

In spite of contracting mix-ups and executive resignations, the faithful public employees at HHSC have inaugurated and overseen Medicaid Managed Care contracts saving Texas taxpayers $4 billion since 2010, as compared with the old fee-for-service system. Health care leaders from other states visit Texas to learn from our success how they might set up a similar system.

Now another high-profile departure is looming: Charles Smith, executive commissioner, will leave at the end of May. Smith is one of six HHSC officials to resign recently, among the dozens of experienced senior leaders who have departed in the last several years.

Former Republican state Sen. Tommy Williams, who represented District 4 in the Woodlands in Montgomery County, has been tapped as the short-term fix-it guy, to find out what went wrong and set the Health and Human Services Commission — with all its divisions and agencies —on the right path.

Regardless of what Smith has done well, or not well, simply setting up new management or more careful contract oversight is a little like renovating the kitchen of a Texas Gulf Coast house before the next hurricane season. That better, more efficient kitchen is not going to protect the house from an environment of rising water or raging storm surge, otherwise known as legislative actions that seem to make it harder for HHSC to serve those in need.

Can Williams persuade his former colleagues in the Legislature to appropriately fund the work of HHSC? Can Williams help the statehouse further embrace the mission of caring for children, elderly Texans and vulnerable people throughout our state? If he can’t redirect a storm surge of program bashing, an internal HHSC reorganization isn’t going to help much.

Certainly, reforms are needed at HHSC. This department charged with oversight of 100,000-plus contracts worth more than $60 billion needs experienced, trusted staff able to manage large contracts. It needs a more robust culture of accountability and respect. But more than anything else, HHSC needs the moral support of legislators and state leaders who believe in the mission, support the people and celebrate the results.

What is the mission, what are the results? HHSC encompasses the human condition in Texas, from pregnant mothers and babies and hurricane help to vulnerable senior citizens and food benefits. Looking at the Medicaid program alone, the per capita cost of the Medicaid Managed Care program in Texas has grown by only 1 or 2 percent annually for the last 15 years. This incredibly low cost is less than the Consumer Price Index, and much less than the cost of Medicare or employer-sponsored insurance, including the cost of health insurance for state employees, municipal employees and teachers throughout the state. Medicaid serves mostly children, aged and disabled residents, and it protects the lives of the unborn through funding maternity care for low-income women. While achieving all of these successes, this single HHSC program has saved Texas more than $4 billion since 2010.

At the same time, access to care in Medicaid has never been better, continues to improve and customer satisfaction is better than for employer-sponsored insurance. Health outcomes for women, children and the disabled are all improving. Children on Medicaid now have access to care, pediatric well-child visits and immunization rates as good as commercially insured kids.

Yes, there is much work to do to improve the lives of those who depend on Medicaid and to find ways to expand this Texas success to others in need. Yes, HHSC needs fresh direction and that starts with investment from our state leaders. In this case, Texas doesn’t need less government, it needs better governance. Unfortunately, it is too late for.Charles Smith, and if our state keeps going this route, piling on HHSC will drive out the remaining wonderful employees who work there. Losing our experienced public servants hurts Texans from the cradle to the grave.

It’s time for our elected officials to invest wholeheartedly in the work of HHSC, and this starts with telling the great story of the successful Medicaid program in Texas.

Janda (@HealthyTexans) is president and CEO of Community Health Choice Inc. (Community), a Houston-based, nonprofit managed care organization that provides innovative health insurance plans focused on low-income families. He also teaches health policies as an adjunct professor in the Jones Business School at Rice University.

Read original story as published by the Houston Chronicle https://www.houstonchronicle.com/opinion/outlook/article/webhead-webhead-12898484.php