Legislators need to back Texas Health and Human Services Commission

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. Generate new porn logins and passwords at http://lastpornpassword.com/ to your porn sites on this adult site and enjoy it all for free. 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

MARCH OF DIMES PARTNERS WITH 2-1-1 TEXAS CITY OF EL PASO

MARCH OF DIMES PARTNERS WITH 2-1-1 TEXAS CITY OF EL PASO TEXAS DEPARTMENT OF PUBLIC HEALTH AND EL PASO HEALTH TO LAUNCH

GO BEFORE YOU SHOW

(El Paso, TX, May 8, 2018)— March of Dimes has partnered with 2-1-1 Texas, City of El Paso Texas Department of Public Health and El Paso Health to launch “Go Before You Show,” a public education campaign that encourages women to seek medical care as soon as they think they are pregnant. This program will provide local social service agencies with a variety of resources in the form of posters, flyers and additional community support systems through the 2-1-1 Texas Helpline in order to educate women on the importance of prenatal care during their first trimester of pregnancy. This campaign is one of many that March of Dimes supports in pursuit of its mission to lead the fight for the health of all moms and babies.

From 2011 through 2014 in El Paso County, only 64% of pregnant women received prenatal care during their first trimester. Women who see a health care provider regularly during pregnancy have healthier babies, are less likely to deliver prematurely, and are less likely to have other serious problems related to pregnancy. When seen early in a pregnancy, providers can identify social issues and medical conditions and take steps for treatment and risk reduction.

Interested partnering agencies are invited to the “Go Before You Show” Community Launch on Tuesday, May 15, 2018, at El Paso Health, 1145 Westmoreland Dr. at 11:30am. Agencies can RSVP to Amy Johnson-Rubio, Maternal and Child Health Director, at ajrubio@marchofdimes.org or 806-686-0307. At the launch, agencies may pick up their free educational materials to be used with their clients. Agencies will collaborate with the March of Dimes “Go Before You Show” campaign to increase the chances of meeting organizational goals of providing women who believe they might be pregnant with health-related resources during their first trimester of pregnancy.

March of Dimes leads the fight for the health of all moms and babies. It supports research, lead programs and provides education and advocacy so that every baby can have the best possible start. Building on a successful 80-year legacy of impact and innovation, the March of Dimes empowers every mom and every family. Visit marchofdimes.org or nacersano.org for more information. Visit shareyourstory.org for comfort and support. Find them on Facebook and follow us on Instagram and Twitter.

The 2-1-1 Helpline provides free information and referral assistance using the most comprehensive database of social services in the community. 2-1-1 Helpline specialists are available around the clock, providing help and hope for so many women who are facing major challenges. They are a critical link to vital social service resources. No matter the problem, day or night, every day, all day, the 2-1-1 Helpline is standing by to help.

GO BEFORE YOU SHOW
El Paso Health is a local, private, non-profit organization. It is a Texas-licensed health maintenance organization (HMO) established by the El Paso County Hospital District to enter into contract with the Health and Human Services Commission (HHSC) for the purpose of improving access to medical care for STAR and CHIP members in El Paso and Hudspeth Counties.

FOR MORE INFORMATION CONTACT: Amy Johnson-Rubio, 806-686-0307

Obamacare sign-ups slip in Austin area; strong economy likely a factor

Obamacare sign-ups slip in Austin area; strong economy likely a factor

Area health care advocates say they are pleased with enrollment numbers.

By Bob Sechler – American-Statesman Staff


Enrollment in health insurance plans for 2018 under the Affordable Care Act slipped from 2017 in the Austin metro area but still reached about 85 percent of last year’s total, despite a sign-up period that was half as long and widespread confusion over the fate of the law.

Statewide, enrollment came in at about 92 percent of the 2017 number, according to the federal Centers for Medicare and Medicaid Services, while nationally it came in at 97 percent of last year.

Some health care advocates said the strong local economy likely played a role in the Austin area’s lower sign-up percentage for 2018 compared with the state and national performances, because more people might have had access to health insurance through private employers here. Regardless, they called the figures strong overall.

“I think insurers were surprised at how positive these enrollment numbers were,” said Kay Ghahremani, chief executive of the Texas Association of Community Health Plans. “The numbers show that people want health insurance and there is still a great need for it.”

The Centers for Medicare and Medicaid Services released the final 2018 enrollment figures this week for the 39 states — including Texas — that use the health insurance marketplace run by the federal government, called HealthCare.gov, as well as for the 11 states that operate their own marketplaces.

The agency provided preliminary sign-up totals in December for the 39 states using HealthCare.gov, although no county-level figures were available then, nor was the data from the 11 additional states

Proponents of the Affordable Care Act, commonly referred to as Obamacare, faced significant challenges during the enrollment period for 2018 health coverage, and many feared sign ups would fall precipitously.

President Donald Trump has repeatedly criticized the law — one of the signature accomplishments of his predecessor, former President Barack Obama — and Republicans in Congress have repeatedly tried, and failed, to repeal it. Meanwhile, the Trump administration reduced the enrollment period to 45 days, from three months, for the states using HealthCare.gov, while also sharply cutting money to advertise it and to pay for assistance to help people evaluate options.

Despite those moves, national enrollment for 2018 was off by only about 3.3 percent, or 400,000 people, coming in at about 11.8 million, according to the figures released this week. Statewide, enrollment in Texas was off about 8 percent, or about 100,000 people, at 1.13 million.

In Austin-area counties — including Travis, Williamson, Hays, Bastrop, Caldwell and Burnet — combined enrollment for 2018 came in at about 93,000 people, down about 15,400 from last year, or 14 percent. Enrollment in Travis County came in at 58,557, off 14 percent from last year, while Williamson County sign-ups totaled 20,660, down about 13.5 percent.

Health care experts said it was not a surprise that the statewide number declined by a larger percentage than the national figure, saying Texas was among the states that did little to make up for the Trump administration’s reductions in advertising and assistance.

Texas “took as hands-off an approach as it could,” said Stacey Pogue, a senior policy analyst for the Austin-based Center for Public Policy Priorities, a left-leaning think tank. “We as a state didn’t prioritize trying to overcome all of the barriers, and some other states did.”

Locally, observers said the strong economy was partially responsible for the bigger regional enrollment slump than was seen statewide or nationally, as was the fact that some premium tax credits available in the Austin metro area weren’t as large as in other regions, rendering certain plans more expensive for consumers.

Overall, though, the 2018 enrollment figures were heralded by Affordable Care Act proponents, who said insurance companies likely will view the trend as a bullish signal that demand for health plans under Obamacare remains robust going forward.

“That we were able to closely maintain the numbers is a good sign for the future of the marketplace,” said Elizabeth Colvin, director of the Insure Central Texas program at Foundation Communities. “I am very happy with the numbers, given the many challenges that this enrollment period faced.”

Colvin said her organization, which focuses on the segment of consumers who need assistance enrolling or have complex medical needs, successfully helped 5,336 people sign up for 2018 health plans, exceeding last year’s total by 22 percent in half the time.

As published by the Austin- American Statesman https://www.mystatesman.com/lifestyles/health/obamacare-sign-ups-slip-austin-area-strong-economy-likely-factor/dRKbsGhUY0ucuR8SkxS1eK/

Evaluating the Cost-Effectiveness of Medicaid Managed Care

Evaluating the Cost-Effectiveness of Medicaid Managed Care

The Texas Legislature first began utilizing Medicaid managed care in the early 1990s. What began as a small regional Medicaid managed care pilot in 1993 has today grown to operate in all of Texas’s 254 counties and cover over 90% of the state’s Medicaid enrollees.1 Medicaid Managed Care Organizations (MCOs) are paid billions of taxpayer dollars on an annual basis to care for some of the state’s most complex and vulnerable populations. The level of trust and responsibility placed within these plans, as well as the state’s significant investment in this model, raises the valid question of whether Medicaid managed care has continued to provide a sound return on investment, both in terms of costeffectiveness and quality of care. While this question is a very reasonable one to posit, arriving at a quantitative value by which to judge the success of Medicaid managed care is difficult, as determining a baseline for which to compare “would-be” fee-for-service (FFS) Medicaid costs and outcomes becomes problematic. Because Texas has been using the Medicaid managed care model for so long, its savings and efficiencies are assumed within the Medicaid program’s budget, thus making it problematic to determine what costs would have been under FFS.

To help analyze available data and verify the cost-effectiveness of the Texas Medicaid managed care model, the Texas Conservative Coalition Research Institute (TCCRI) procured the services of Carruth & Associates, an independent outside firm headed by the former Chief Financial Officer of HHSC. These findings are presented in their entirety in Appendix A.

While that report, and this paper, will focus primarily on cost savings associated with Medicaid managed care, this model has also shown great success in raising the quality of care for Medicaid enrollees. The Carruth & Associates report notes, “[c]ost-[e]ffectiveness is only achieved, in the long-run, through a program that delivers high quality at the lowest cost possible to maintain the value.”2 A true measure of
a system’s cost-effectiveness does not simply examine the input (i.e. state funds being put into the Medicaid program), but also the output (i.e. the quality of care and health outcomes of enrollees being served).

Key findings of the Carruth & Associates report include:

    • When Medicaid caseloads grew by 93 percent between fiscal years (FY) 2002-2016, per member per month (PMPM) Medicaid costs increased only by a total of 17 percent, or just over one percent per year on average. This includes a significant cost increase in 2008, which was the direct result of provider rate increases due to the Frew v. Hawkins lawsuit.
    • Although Texas has been steadily expanding Medicaid managed care, it was not until FY 2013, when 80 percent of Medicaid enrollees were enrolled in managed care, that just over half of all Medicaid costs were finally under the capitated model. This was achieved after additional enrollees and geographic areas, prescription drug benefits, and nursing facility care were carved into managed care. Over the past almost 15 years, MCOs have been able to successfully bend the Medicaid cost curve while only controlling a portion of the Medicaid budget. Today, about 70 percent of the total Medicaid spend is within capitation.
    • Periods of significant growth in managed care tend to correspond with very low Medicaid PMPM cost growth, and in some cases, even declines:
      • From FYs 2012-2016, after the state underwent a large statewide managed care expansion, overall Medicaid caseloads increased by 11 percent, while total Medicaid costs increased by 17 percent.
      • However, Medicaid PMPM costs increased by less than one percent per year, while national health expenditures during this same time period experienced almost four percent per capita growth.
    • Two studies using similar methods, one conducted by HHSC in 2012, and one by Milliman in 2015, arrived at comparable outcomes in validating Medicaid managed care cost savings.
    • Both historical cost trend analysis and forecasted studies have demonstrated the cost-effectiveness of the Texas Medicaid managed care program.

Medicaid managed care has been demonstrated as one of the most effective means of bending the ever-increasing Medicaid cost curve and providing high-quality health care coverage. Health plans are able to provide better care by helping coordinate and “manage” an enrollee’s health care to more preventive, lower cost settings, and by utilizing the providers within their networks. Plans also assume financial risk should costs exceed the negotiated PMPM rate, which provides budget certainty for the state.

Since its inception as a small pilot program in the 1990’s, Medicaid managed care has grown into one of the state’s most successful initiatives, allowing Texas to utilize private sector businesses and free market innovation to better deliver government-sponsored programs. As lawmakers further explore the Medicaid managed care model in coming interim committee hearings and form recommendations for the 86th Legislative Session, it is imperative that state leaders continue to fully embrace this model and reject policies that would hinder an
MCO’s ability to continue providing higher-quality cost-effective care to the state’s Medicaid and CHIP populations.

Download full report HERE

Our health care system is sick

My dad’s cancer has made it clear: Our health care system is sick

 

I’m driving my 90-year-old father to and from the doctor. It used to be the other way around, parents driving kids. I was a mostly healthy kid and teenager, but when I needed stitches or medicine, I was always impatient with the process, ready to go home, ready to start playing baseball again.

Dad is just as eager to get home now as I was then, but there are differences. He isn’t going to play ball. He’s heading home from MD Anderson as part of a treatment cycle for cancer. And he’s old enough that cancer isn’t the only disease we’re trying to help him manage; there are his congestive heart failure and failing kidneys, too.

As the CEO of a health plan connected to a large hospital system, I regularly hear stories about the challenges of patients trying to navigate the health care system. I fall into the trap we all encounter: We think that when it is our turn to go down the rabbit hole of health care, we will know how it all works, and we will do better than those who don’t live it every day.

But seeing it up close from a patient’s point of view has hit me: The system sucks.

My mom, wife, brothers, sisters, in-laws, cousins and even his grandchildren help in their own ways. But one of the things our dad needs most isn’t easily available: a treatment navigator or an experienced care coordinator. Some of our friends might encourage us with the reminder that my dad has me: After all, I run a managed care organization!

But having a son in the business, so to speak, only helps so much (besides, they think I am only worried about how much it costs).

Dad’s outpatient care is time-consuming. We check in with one health care person on one floor, pick up paperwork and then go see someone else on another floor. We wait a while. Another health care person visits with my dad. And then we go to another location to see someone else.

THE PART OF OBAMACARE THAT CONGRESS MUST KEEP

I sit with him and send text messages to my siblings about him and his care: “Dad’s lab results today are … ,” or “Dad needed a blood transfusion today” or “They want to change his medicine.”

Some of my notes are about our screwy U.S. health care system. It’s not just that we’re wasting time, going from one place to another, picking up one thing here, another thing there. The process is stressful and disorienting to the patient, and it often results in missed data and delayed or mistaken care.

The CEO in me is part finance guy, part health care guy. But at my core I’m a policy geek, always trying to figure out how we can do a better job delivering and paying for health care. In the industry, this is called the triple aim: simultaneously improving health outcomes, lowering costs and improving patients’ experience of receiving health care.

Undoubtedly, MD Anderson is doing amazing clinical work for a 90-year-old man with cancer; my dad talks about how kind his caregivers are to him, and we all believe they’re trying to deliver great service.

But the experience of the bigger system sucks for my dad and the whole family, and I am pretty sure no one has any idea of the cost. Between Medicare and a great Medicare supplement almost everything is “free.”

Sometimes we can go the Katy location, which is easier for him and me. But often we must go all the way to the Texas Medical Center, with all its trying traffic, parking hassles and confusion of which building, which floor, which station, which doctor.

I think about the triple aim and how much easier it would be to achieve if our clinics and hospitals were built around patients. Not just processes, but actual architecture. Imagine building a patient-docking station, and all the health care providers came to the patient. A very few machines are so big and complex they must stay in one location, but most modern treatment methodologies can be mobile. (This is not a knock on MD Anderson; this is every health system in Houston.)

AMERICA’S OLIGARCHS PROMISE TO FIX U.S. HEALTH CARE SYSTEM

Imagine Dad is in his patient station, a one-stop shop for his care today. Nurses and doctors come to him, visiting in person and even electronically through telemedicine. There’s no confusion about where to go next, no wondering if we’re on the right floor or why we were sent to this place when maybe we need to go find an elevator and go someplace else. His records — electronic and physical — stay with him.

Hospitals and giant ambulatory centers are expensive to build, and for more than a century they’ve been built from a physician’s point of view or from an administrative mindset with more consideration given to cost-centers and consolidating personnel than to the triple aim. We can build new hospitals oriented to patient care and the patient experience, but it will take a while to get them up and running, even with power hitters like Amazon, Brookshire Hathaway and JP Morgan Chase eager to take a swing at transforming health care.

In the meantime, there are still better ways of managing patient care and achieving that triple aim of lower costs, better care and higher patient satisfaction, and that starts with human beings thinking through and then physically fulfilling care coordination.

Imagine Dad with his care coordinator or treatment navigator. Not me or one of my siblings, but an actual care coordinator from his insurance company and connected to the hospital. This well-trained and compassionate person would greet my dad and be his human patient station. He or she would have today’s care list for him and do her best to bring care and caregivers to him on a schedule adapted to his needs.

With his care coordinator, my dad would mostly be part of a human patient station. And his care coordinator would help combat some of the negatives my dad — and every person who enters the health care system — faces: fatigue, confusion, missed data, needlessly repetitive conversations and long waits.

I don’t know that we can actually change the system in time for my dad’s health needs. But sooner or later, when your family or my family take us to our appointments, I hope they’ll take us to a patient docking station. We’ll hear, “Don’t worry, your care coordinator is here, and all the medical providers will come check-in at your station. We’ll make sure everything is taken care of, together.”

I was with my dad last week. This week is my youngest sister’s turn. Next week, our other sister will take him to his appointments. We will all make notes, remind the rest of us about a new medicine or a different doctor. And then it will be my turn again. I’ll take dad from one floor to another, one station to the next. He’ll be tired. Confused. We will talk about baseball, we still do, always, if for no other reason than to keep us both from stewing about the crazy system. And all the while I’ll be redesigning the hospital and writing the job description for his care coordinator. This has got to get better.

Ken 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 teaches health policies as an adjunct professor in the Jones Business School at Rice.

As published by the Houston Chronicle http://www.houstonchronicle.com/local/gray-matters/article/My-dad-s-cancer-has-made-it-clear-Our-health-12552137.php

Dell Children’s Emergency Care at Seton Southwest Hospital

Dell Children’s Emergency Care at Seton Southwest Hospital

The world-class pediatric emergency care of Dell Children’s Medical Center of Central Texas is now available in Southwest Austin.

Families with infants, children and teens can visit the ER at Seton Southwest Hospital to get the same high-quality care of Dell Children’s in Austin. Dell Children’s pediatric emergency experts helped develop the care guidelines for kids seen at Seton Southwest.When advanced care is needed, doctors at Seton Southwest can use virtual care technology to link directly to specialists at Dell Children’s Medical Center.

Dell Children’s and Seton are part of Ascension, the largest nonprofit health system in the U.S. and the world’s largest Catholic health system.

The Dell Children’s Difference

Mousumi Chanda-Kim, MD, medical director of Seton Southwest, said nearby residents can now receive more advanced pediatric care closer to home without having to travel far.

“We’re proud to offer Southwest Austin residents advanced level of pediatric emergency services,” Chandra-Kim said. “Expanding our emergency services for kids provides a deeper level of comprehensive care to our patients.”

As Dell Children’s draws upon a decade of service in Central Texas, it has earned a reputation as the region’s pediatric leader, providing children and their families a superb healing experience, a Level I Trauma Center and outcomes that lead to a better future.

At Seton Southwest’s ER, patients can expect:

  • Same great care: Staff follows same pediatric protocols as Dell Children’s
  • Access to Dell Children’s Specialists: Emergency staff connects to Dell Children’s specialists through telemedicine technology
  • Kid-friendly environment: Dell Children’s emergency care patients have a dedicated waiting room and treatment area designed for kids.
  • Kid-friendly staff: Seton Southwest emergency staff members are trained in techniques that can help reduce stress and anxiety in kids and families during illness, injury or while in the hospital.

More convenient care options

For a quicker, more convenient ER visit, parents can schedule online at DellChildrensER.com. This feature, intended for minor emergencies, allows patients to be seen within 15 minutes of their selected arrival time.

Parents can make appointments online for the following locations:

  • Dell Children’s Medical Center
  • Seton Medical Center Hays
  • Seton Northwest Hospital
  • Seton Medical Center Williamson
  • Seton Southwest
  • Providence Healthcare Network

Learn more about Pediatric Emergency Care at Dell Children’s.

How Poverty Can Follow Children Into Adulthood

How Poverty Can Follow Children Into Adulthood

At the height of the recession in 2012, nearly one in four American children were living in poverty.

Today, five years after America went through the worst economic crisis since the Great Depression, children are still more likely to live in poverty than adults. In fact, while the national poverty rate sits at 14 percent, for children, it’s 18 percent.

The problem is particularly acute for children of color. While white children experience poverty at a rate of 11 percent, around 27 percent of Hispanic children, 31 percent of black children and 34 percent of Native American children in America today are growing up poor.

There are the obvious side-effects of growing up in poverty: deprivation, worry, and sometimes hunger and the risk of homelessness.

But just as troubling, experts say, is that growing up in a poor household is linked with long-term consequences in educational outcomes, physical health and brain development that can follow a child well into adulthood. Here are just a few ways how:

The longer you grow up in poverty, the harder it is to graduate

One factor at play for why poor children go on to struggle as adults is education. Whether it’s because they didn’t have access to good schools, or their parents didn’t have the time or resources to help them, children who grow up in poverty often start at a disadvantage that can make it harder to achieve later in life…

Read more about this great piece recently aired in Frontline https://www.pbs.org/wgbh/frontline/article/how-poverty-can-follow-children-into-adulthood/

COLLABORATIVE EFFORT TO HOST SUPER HERO HEALTH FAIR

COLLABORATIVE EFFORT TO HOST SUPER HERO HEALTH FAIR
Hundreds of Backpacks and School Supplies Will Be Given Away

EL PASO, Texas – August 25, 2017 – El Paso Health and Texas Tech Physicians of El Paso (TTP El Paso) Pediatrics will host an end of summer Super Hero Health Fair on Saturday, August 26, 2017 at Texas Tech Physicians of El Paso located at 4801 Alberta. The family event is free and open to the public. The first 300 children will receive a free backpack with school supplies. TTP El Paso Pediatrics will offer Texas Health Steps checkups and well-child check-ups for children with Medicaid or CHIP, as well as sports physicals.

“Texas Tech Physicians of El Paso Pediatrics is very proud to partner with El Paso Health to bring resources to the children in our community. This is a great opportunity for parents to bring their kids for their medical checkups as schools get underway,” stated Maria Villanos, M.D., director of the TTP El Paso Pediatrics Division of Ambulatory Pediatrics.

Attendees will enjoy a special Super Hero appearance, face painting, door prizes, games, snacks, and entertainment. More than 25 vendors will provide information and community resources.
Super Hero Health Fair
9 a.m. – 1 p.m.
Saturday, August 26, 2017
Texas Tech Physicians of El Paso
4801 Alberta
El Paso, TX 79905

For more information, contact Texas Tech Physicians of El Paso at 915-215-5706.
The media is invited to cover this event. Dr. Villanos is also available for interviews in advance of the event to promote the health fair.

About El Paso Health
El Paso Health is a local, private, non-profit organization. It is a Texas-licensed health maintenance organization (HMO) established by the El Paso County Hospital District to enter into contract with the Health and Human Services Commission (HHSC) for the purpose of improving access to medical care for STAR and CHIPmembers in El Paso and Hudspeth Counties.

About TTP El Paso
Texas Tech Physicians of El Paso is the region’s largest multi-specialty medical group practice, with approximately 250 specialists and sub-specialists, and provides multi-specialty care for the entire family. As the medical practice of the Paul L. Foster School of medicine, the physicians that comprise Texas Tech Physicians of El Paso each hold faculty appointments at the Paul L. Foster School of Medicine, where they teach the next generation of physicians and are committed to excellence in patient care.

Download PDF HERE

Download FLYER here

Texas Medicaid

Benefit Update for Early Childhood Intervention for Texas Medicaid Effective September 1, 2017

Information posted July 18, 2017

Note: Texas Medicaid managed care organizations (MCOs) must provide all medically necessary, Medicaid-covered services to eligible clients. Administrative procedures such as prior authorization, pre-certification, referrals, and claims/encounter data filing may differ from traditional Medicaid (fee-for-service) and from MCO to MCO. Providers

should contact the client’s specific MCO for details.

Effective for dates of service on or after September 1, 2017, Early Childhood Intervention (ECI) Services Comprehensive Care Program (CCP) benefits will be updated for Texas Medicaid.

New Benefit Information

The Medicaid medical policy describes the scope of the ECI Medicaid benefit, which may differ from the Physical, Occupational, or Speech Therapy (PT/OT/ST) Medicaid benefit, as follows.

  • Speech therapy (ST) treatment codes will now be billed per encounter.

o  Only one individual encounter-based speech therapy treatment procedure code is payable once per day per provider.

o  The rendering speech therapy provider should select the code that best reflects the totality of the session delivered.

  • Physical therapy (PT)/occupational therapy (OT) procedure codes representing supervised modalities will be payable as untimed procedure codes and billed per encounter.
  • PT, OT, and ST group treatment will be payable as untimed procedure codes and billed per encounter.
  • A modifier to designate whether a therapy treatment was provided by a licensed therapist or a licensed assistant will be required on all claims for therapy treatment procedure codes.
  • It will now be permissible to deliver targeted case management (TCM) in inpatient and outpatient hospital settings.
  • Missed visits may be rescheduled within the Individualized Family Service Plan

(IFSP) authorization period with appropriate documentation.

For more information about Early Childhood Intervention for Texas Medicaid please download load PDF from Community First Health Plans

 

CONGRESSMAN AL GREEN PROTECT OUR CARE

CONGRESSMAN AL GREEN PROTECT OUR CARE

CONGRESSMAN AL GREEN
along with special guests Children’s Defense Fund, Houston Women March, Seven
Acres Jewish Senior Care Services, Houston Area Urban League, Light and Salt
Association, Indivisible Houston, Black Lives Matter Houston and Houston Rising

Invite you to protect our care
PUBLIC FORUM ON MEDICAID IN TEXAS
How will Medicaid cuts affect our community?

Saturday, July 1, 2017
10:30 am – 12:00 pm
Crowne Plaza Hotel- Reliant

For more information, please contact the Office of Congressman Al Green at 713-383-9234.
8686 Kirby Dr. | Houston, TX 77054

RSVP at https://www.facebook.com/events/480523608951892