Texas House Bill HB3158

Texas 2013 - 83rd Regular

Caption

Relating to Medicaid managed care pilot programs for contracts with provider-directed managed care organizations, including organizations that delegate to health care collaboratives, and to the establishment of those collaboratives.

Impact

The impact of HB 3158 is significant in transforming certain aspects of Medicaid services. The establishment of pilot programs could lead to innovative approaches in managing care, addressing both cost-effectiveness and quality of patient care. By focusing on larger service areas with substantial Medicaid recipient populations, the bill is designed to improve the overall health service delivery mechanism within the state. Pilot programs must also demonstrate effectiveness to be considered for broader implementation thereafter.

Summary

House Bill 3158 involves the implementation of Medicaid managed care pilot programs within the state of Texas. This bill specifically authorizes the Texas Health and Human Services Commission to develop and operate pilot programs that contract with provider-directed managed care organizations. Key objectives include enhancing the efficient utilization of medical services and maximizing patient outcomes while controlling costs. The bill proposes a testing framework for various service delivery models and aims to explore the feasibility of healthcare collaboratives in Texas.

Contention

Notable points of contention surrounding HB 3158 include concerns about the efficiency and effectiveness of managed care organizations versus traditional fee-for-service models in Medicaid. Stakeholders may have differing views on whether the delegation of care management to provider-directed organizations enhances the quality of care or poses risks, such as reduced access to services or increased administrative burden. Additionally, the necessity of federal waivers for certain implementations may introduce complexities, particularly if the waivers are not granted timely.