The Texas Primary Care Consortium (TPCC) outlined its 2023 policy priorities during a virtual presentation on Thursday, placing legislative efforts around maternal healthcare, Medicaid modernization, and transition to value-based payments at the forefront.
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Led by the Texas Medical Home Initiative and the Texas Health Institute (THI), TPCC is a statewide, collaborative initiative with a mission to advance equitable, comprehensive, and sustainable primary care for all Texans.
Referencing bills that sought to expand the scope of Medicaid, TPCC supports measures extending postpartum coverage to 12 months and addressing non-medical drivers of health.
A panel representing various parts of the state’s healthcare system—including providers, payers, purchasers, and patients—helped identify the legislative priorities this session and put forth a unified framework toward systemic change.
Organizations represented on the panel included the Texas Medical Association, the Texas Association of Health Plans, the Texas Association of Community Health Centers, and the Texas Nurses Association.
“Given the systemic and chronic nature of our challenges, this journey for us has also been both gratifying and encouraging because when you bring like-minded and committed individuals in a room, the package of priorities we have really underscores that collaboration and consensus building [are] possible,” THI Executive Director Ankit Sanghavi said. “During this current session, [the priorities] are organized into the three buckets of increasing access to care, promoting value-based payment, and strengthening primary care.”
Texas ranks last in the nation in healthcare access and affordability, with 5.2 million Texans uninsured and 27% of residents without a primary care physician, according to TPCC. Texas leads the country with 26 rural hospital closures since 2010 and has 32 counties without a primary care provider, further exacerbating issues around access for the nation’s largest rural population (3.8 million residents).
Sanghavi said it was imperative for the state to advance solutions that reduce the number of uninsured Texans. He advocated for options like expanding Medicaid coverage as well as investing in healthcare navigators and community organizations that can assist eligible Texans with applying for either Medicaid CHIP or federal marketplace premium subsidies.
“Infrastructure needs to be upgraded but also needs to have the right capacity to help support this enrollment,” Sanghavi said. “And we truly support all efforts … that simplify signups and renewals through our Medicaid system, which includes ensuring that there is adequate staffing of the eligibility system, [and that] there is increased automation and use of reliable data sources to increase the rate of data-driven renewals.
We want to support the idea of temporary waivers to renew Medicaid using verified SNAP data and modernize website or mobile applications to make it easier for Texans to complete their critical steps as part of the renewal and signup processes.”
Acknowledging telehealth as a means to improve access and interoperability in health information exchange, TCPP officials called on legislators to strengthen the infrastructure for broadband.
With regard to promoting value-based payments, TCPP advocated for policy actions that facilitate coordination and collaboration amongst payers, providers, and purchasers who operate within this payment environment.
The legislative recommendations put forth by the Texas Health and Human Services Commission’s (HHSC) Value-Based and Quality Improvement Advisory Committee include moving away from an emphasis on meeting alternative payment model (APM) targets and streamlining current APM reporting requirements.
In line with those recommendations, Sanghavi said HHSC should endorse a standard primary care model for Medicaid that managed care organizations (MCO) may voluntarily adopt for providers and give MCOs credit for a broader range of work around value-based care.