Texas Senate Bill SB7

Texas 2011 - 82nd Regular

• Out of Senate Committee: 4/4/11
• Introduced: 2/16/11
• Voted on by Senate: 4/19/11
• Refer: 2/17/11
• Out of House Committee: 5/18/11
• Report Pass: 4/4/11
• Engrossed: 4/19/11
• Refer: 4/28/11
• Report Pass: 5/16/11

Caption

Relating to strategies for and improvements in quality of health care provided through and care management in the child health plan and medical assistance programs designed to achieve healthy outcomes and efficiency.

Impact

The bill proposes to significantly alter the current reimbursement structures for Medicaid and child health services, highlighting a shift towards value-based care. By converting to diagnosis-related group (DRG) methodologies and establishing payment adjustments based on the performance of healthcare providers, SB7 aims to promote accountability and reduce unnecessary healthcare expenditures. This change is expected to improve care delivery and reduce costs associated with potentially preventable events, such as readmissions and complications.

Summary

Senate Bill 7 (SB7) focuses on enhancing the quality of healthcare provided through the Medicaid and child health plan programs in Texas. The bill establishes a framework for quality-based payment initiatives that aim to improve efficiency and health outcomes. The legislation introduces new definitions and guidelines for various payment systems, emphasizing alternative payment strategies that include global and episode-based payments. It also creates a Medicaid and CHIP Quality-Based Payment Advisory Committee to oversee the development of quality measures and reimbursement systems to align with high-quality care standards.

Contention

One of the notable points of contention surrounding SB7 concerns its operational impact on healthcare providers, particularly regarding managed care organizations and hospitals. Stakeholders may raise concerns over the feasibility of implementing the bill's provisions within existing frameworks, especially relating to the balance between incentivizing quality care while ensuring access to necessary medical services. Additionally, there may be apprehensions regarding the potential for increased administrative burdens as providers adapt to new compliance requirements and performance measures mandated by the bill.