Keynote: Stephanie Stephens, Texas Medicaid Director


Eli Kirshbaum


Texas Medicaid Director Stephanie Stephens closed out last month’s 2022 North Texas State of Reform Health Policy Conference with in-depth remarks on the state’s Medicaid program. She discussed the new 1115 waiver and its provisions, the now-permanent changes to Medicaid telehealth policy, and much more. She also stressed the importance of gaining responses to the state’s request for information from residents about changes to Medicaid eligibility in anticipation for the upcoming end of the federal Public Health Emergency.

She noted that the approval of the state’s new 1115 waiver was urgently needed due to the pandemic and the need to support providers in the state.

“We use [the waiver] to continue to expand managed care in Medicaid, to support a coordinated delivery system, to improve outcomes while containing cost growth, and to transition to quality-based payment systems … The waiver includes significant support for providers through directed payment programs and uncompensated care funding, and the providers that are included are primarily hospitals, behavioral health providers, rural health clinics, [and] certain physician groups.”

She also discussed how the Health and Human Services Commission remains committed to proliferating the use of alternative payments models (APMs) in its Medicaid program.

“There’s still continued opportunity to advance alternative payment models … Moving forward, we will continue to promote the adoptions of APMs, but based on the experience we’ve had over the last few years, as well as [the findings of our] Value-Based Payment and Quality Improvement Advisory Committee, we are planning changes to provide a more comprehensive, but still flexible, framework for increasing the adoption of APMs that goes beyond just [the state’s current APM] targets.

One of the things we’ve heard is the targets are helpful in moving the needle, but it’s not the only thing that needs to happen. So we’re looking at [how we can] round out our approach to alternative payment models.”