As a pediatric anesthesiologist in South Texas, I have logged countless hours in operating rooms caring for babies who have undergone multiples surgeries — some in the moments after birth. These have been some of the most heartbreaking moments of my life. Sadly, many of these surgeries could have been prevented if someone had stepped in and provided support to the expectant mothers, taking their hand and walking them through the steps of a healthy pregnancy and delivery, as well as providing special help in complicated preg-nancies.
Much of what I witnessed was under the old way that Texas ran its Medicaid program — the fee-for-service model. Under this approach, the state paid doctors and other providers for the quantity of services they provided — not the quality of those services. Care was fragmented. Ultimately Texas moved to today’s model — the managed care approach — in which the state partners with private health insurers who have the tools and expertise to boost quality while keeping costs affordable. This modern approach lends itself to more flexibility and more creativity, which has led to coordinated care and a focus on prevention. Over the years, both as a physician and today as an administrator with our Medicaid plan, Driscoll Health Plan, I have seen a slow but steady transformation of the Medicaid program in Texas. A snapshot of that transformation is the incredible gains we have made for mothers and babies in South Texas.
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