Texas House Bill HB4365

Texas 2021 - 87th Regular

Caption

Relating to a pilot project to improve health care outcomes and reduce costs under Medicaid by providing participating recipients with enhanced case management and other services to address certain social determinants of health.

Impact

The bill proposes a five-year pilot project that will involve collaboration with Medicaid managed care organizations and various stakeholders to develop and implement strategies that directly respond to identified needs of participants. An important aspect of this bill is that it allows for flexibility in service provision, which can include legal assistance, tenancy support, nutritional counseling, and more. This initiative might lead to a systematic change in how Medicaid recipients approach their health care, potentially contributing to long-term savings in healthcare costs by addressing root causes of health issues.

Summary

House Bill 4365 aims to establish a pilot project to improve healthcare outcomes and decrease healthcare costs for Medicaid recipients in Texas. It focuses on addressing social determinants of health — factors such as housing instability, food insecurity, and transportation issues that significantly impact individuals' health and overall quality of life. By providing enhanced case management and targeted non-medical intervention services, the bill seeks to provide specific support to Medicaid recipients who are at a higher risk of developing serious health conditions due to such factors.

Contention

Key points of contention may arise regarding the funding and implementation of this pilot project, especially concerning the waiver application needed to modify the existing Medicaid plan. Concerns about the effectiveness of non-medical intervention services versus traditional medical care may also surface. Furthermore, there may be debates over eligibility criteria for program participants, as some may argue that they should be broadened to encompass a wider range of individuals facing different health-related challenges. The project is set to expire after five years unless continued by subsequent legislative action, which itself may be a point of contention during evaluations.