5 Things Texas:  Opioids, Topical Agenda, Sendero Health

I hope you’re able to get away and enjoy the Christmas holiday now less than two weeks away – or the recent Hannukah celebration or any other festive or religious event that is on your calendar this time of year.  It’s important that we make time to recharge our batteries – for our mental and physical health, but for our social health as well.

So, celebrate with the family this month – and then come and solve some of Texas’s health policy challenges with us next year!  Our 2019 Texas State of Reform Health Policy Conference is right around the corner on Feb. 5th!

DJ 5 Things SignatureWith help from Marjie High
and Emily Boerger. 

 

 

1. Opioid Select Committee report

The House Select Committee on Opioids and Substance Abuse recently released its committee report outlining their policy recommendations and findings for the 86th Texas Legislature. The select committee held six hearings during the 2017/2018 interim and heard from over 70 expert witnesses to develop the comprehensive, 108-page report.

Out of the report came over 5 pages of recommendations for the 86th legislature, covering a broad range of topics, including: expanding Medication Assisted Treatment, increasing patient data sharing, and supporting telemedicine services for underserved areas. The report also recommended changes to Texas’s “Good Samaritan” laws, and recommended identifying methamphetamine use as a Texas crisis. Our rundown of the report can be found here.

 

2.  Our Topical Agenda is now out!

We have been busy curating speakers for our 2019 Texas State of Reform Health Policy Conference which is rapidly approaching on February 5th. With about 350 senior health care executives and health policy leaders expected, State of Reform has become a “can’t miss” event on the early session calendar. We’ll be exploring policy and politics in healthcare, evaluating opportunities and setbacks in reform, and looking to the future of healthcare in Texas.

Take a look at our newly released Topical Agenda to see what may draw your attention — as always, if you have any suggestions on what we should include or potential speakers, you can send those my way. And check out our Convening Panelto get an idea of those who helped put it together. If you haven’t already registered, we’d be honored to have you join us!

3. An update on health legislation passed during the 85th Legislature

The Texas Senate Committee on Health and Human Services delivered its “Interim Report to the 86th Legislature” at the end of November, highlighting the committee’s recommendations related to its assigned interim charges from the 85th Legislature.

The committee evaluated several health care challenges in Texas, and provided an update on the implementation and success of legislation passed during the last session. We break down the committee’s findings on new legislation related to mental health, maternal mortality/morbidity, and the state’s foster care system in this piece.

4.  Video: Bob Kalin, Molina Healthcare

Bob Kalin is the Vice President of Long Term Care Operations at Molina Healthcare of Texas. He joins us in this edition of “What They’re Watching” to discuss care transitions.

“I think care transitions needs to be one of the top five things that are being looked at right now. And there needs to be resources put into it because when you’re moving from acute to long term, that bounce back from the long term back into the hospital, there’s a huge dollar cost to it — we all know that. But I think more importantly for an individual who’s going through that, there is transfer trauma. It’s the toll on that individual, their quality of life, their quality of care that is really paramount.”

5. Watching Sendero Health’s strategy

One of the more interesting strategies in health care is playing out in Travis County. Sendero Health has struggled financially in recent years, stating that a healthier than normal risk pool has forced the plan to provide offsetting risk adjustment payments to plans with unhealthier risk pools. In 2017, this meant paying 1/3rd of its total revenue, or $47m, to other plans, putting the overall P&L into the red.

The solution has been to go recruit much sicker patients. “If (Sendero) could shift 500 members from subsidy programs, it could receive between $11 million to $24 million in 2019 in net income” through net risk adjustment payments. Central Health, the public sponsor of Sendero, recently overturned a decision to shutter the plan, providing an additional $26m in funds for one more year of operations.