County on 3rd year of health care transformation waiver
By Elsa Maxey
Fort Bend County, more regularly associated with mobility projects and other county infrastructure, is continuing its participation in a 1115 Waiver Program going on its third of a five year effort. In a recent workshop before Commissioners Court, Health and Human Services Director M. desVignes-Kendrick, M.D. presented an overview of the program with highlights of focus areas in behavior health and primary care. This has involved local collaboration with four hospitals in the area – Houston Methodist Sugar Land, Memorial Hermann, St. Luke’s Sugar Land and OakBend Medical Center – and many more partners including Access Health, M.D. Anderson Cancer Center, Texana Center, Fort Bend Regional Council on Substance Abuse, Mental Health America Fort Bend and others.
The waiver program was created by the Centers for Medicare and Medicaid Services, with Texas as a participant. It allows for the expansion of Medicaid managed care, providing incentive payments for health care improvements and directing more funding to hospitals that serve large numbers of uninsured patients.
Commissioners were told that one of the biggest projects locally is the one for crisis invention, which includes Fort Bend Sheriff’s Officer training.
Extending the program past 2016 is considered to be beneficial as this is considered to be a program with minimal taxpayer investment as long as the federal government keeps it alive. Access Health Executive Director Carol Edwards extended appreciation to commissioners citing a notable example relating to the program’s impact. A patient of Access Health made 25 trips to the OakBend emergency room on Fort Bend County ambulances, she said. “This is a patient we’re intervening with on care management with multiple needs and this may be the best way to save money for the county as well as for the hospital to get people into the right part of care.”
Under the Medicaid Program, waivers were created for states to test new or existing ways to deliver and pay for health care services. The 1115 Waiver Program is one of four primary types of waivers and demonstration projects financing and delivering Medicaid and the Children’s Health Insurance Program. In December 2011, the Centers for Medicare and Medicaid Services approved Texas for a Section 1115 Waiver, which allowed services in the state with Medicaid and Medicare funds that would otherwise conflict with provisions of the Social Security Act. This expands Medicaid managed programs and establishes federal funding pools to help providers cover the costs of uncompensated care and promote health system transformation. The waiver is in effect through the end of September 2016.
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