5 Things Texas: Charles Smith, Amazon, “What you missed”

We are still coming down from hosting so many good friends at our 2018 Texas State of Reform Health Policy Conference one week ago, today!  It was a wonderful event, and we were very honored to host about 300 of you in Austin.

But, time stops for no one!  So, let me offer you these 5 Things We’re Watching in Texas health care for February.

DJ 5 Things Signature

1.  Amazon shines light on the poor opinion of health care

In September, I outlined a strategy for Amazon to enter the health care space. It starts with leveraging their own employees, which appears to be the focus of their release last week. What has also gained focus is how the Amazon release characterized the health care sector. Warren Buffett called health care a “tapeworm.”  I thought that was a brazen term, but apparently it wasn’t.

A CEO of one of the nation’s largest health systems, Providence Health and Services, agreed.  The former editor of Modern Health care kind of defended the sector saying, to paraphrase, ‘no, it’s a cancer not a tapeworm.” Kaiser Health News posted a letter saying health care is a “catastrophic failure.” Piers Morgan, one I am generally loathe to quote about anything, said health care was “a sick joke & the envy of no one.”

Put it all together:  there is not another sector in the US economy as openly ridiculed and derided as the one upon which we will all one day depend, and from which we will all receive services that few of us can afford on our own. That’s the stuff of a strong political backlash ahead.

2.  What you missed in Austin last week

If you weren’t able to make it to our 2018 Texas State of Reform Health Policy Conference last week, don’t fret…!  We’ve got some of what you missed available at stateofreform.com.

Our highlight reel gives you a snapshot of the sentiments, players, and conversations that took place in Austin.  You can see some of the presentations that were delivered here.  And, we’ve captured our plenary discussions and presentations for you to review, too.  Former Oregon Gov. John Kitzhaber gave stirring and well received remarks to start the day.  Our Executive Keynote Panel discussion took up the lunch session.  And, HHSC Commissioner Charles Smith closed out the afternoon.

Thank you to our sponsors, our speakers, and our conference participants.  We were thrilled to host you all!


3. Mental health services waiting lists

The Texas Health and Human Services Commission has released its quarterly report on the number of adults and children on waiting lists for mental health services, including those in the former NorthSTAR service area. According to the report, 1,118 adults and 5 children are on waiting lists to receive community mental health services. When measuring underserved adults and children, 896 adults and 109 children are on waiting lists. Fortunately, the report also shows that in this first quarter, 2,432 adults and 90 children were removed from lists.

The Appropriations Act of the 85th Legislature specifically allocates over $31 million in funding to eliminate waiting lists and increasing capacity to avoid future waitlists. So far, the report says no money allocated from the Appropriations Act has been used to remove people from these lists, but expenditure data will be included in the second quarterly report.

4.  Charles Smith on contract management

Last week, the State Auditor’s Office released a report showing that HHSC made three errors in its Medicaid managed care contract with Superior HealthPlan. Speaker Joe Straus criticized the HHSC’s management, which cost the state an additional $29.5 million, and called for an investigation.

Commissioner Smith addressed the criticism during his keynote at our conference last week. “Contract management is another one of these areas that has to be considered. It’s our responsibility as the agency that oversees Medicaid and the managed care model to make sure that we’re providing proper oversight of our contracts. We’re not perfect, haven’t been perfect, probably aren’t going to be perfect going forward in the future. But what we’re going to do is we’re going to continually get better. ”

While this moment is one Smith is taking seriously, overall it appears that things at HHSC have settled in and stabilized over under his leadership. Hiring an almost full complement of staff is one key step. Finalizing the 1115 waiver is another.

5. Video: Matt Feehery, Memorial Hermann

Matt Feehery is the Senior Vice President and Chief Executive Officer of the Memorial Hermann Prevention and Recovery Center. Feehery has worked in the addictions treatment field since 1979. He’s well-respected in the healthcare community, having served on the Texas Association of Addiction Professionals and the Behavioral Health Services Council for the Texas Hospital Association. He joins us in this edition of “What They’re Watching” to discuss coverage for behavioral health.

“In terms of what happened in the last legislative session, we had a victory in that the Texas Department of Insurance now has regulatory authority to oversee practices by insurers in our state. Now, it doesn’t cover every insurer because if the company happens to be self-insured they fall under more federal rules rather than the State TDI. In that, what it does it that there are various ways that benefits are monitored or handed out, so to speak.”