Texas will have to develop health plan for future of delivery system reform efforts

State & Regional

AUSTIN (Nexstar) — A funding pool with approximately $3.1 billion currently allotted for Texas will run out in 2021, meaning there will be no dollars available after that point to pay for services that millions of the most vulnerable Texans currently access. 

It’s the Delivery System Reform Incentive Payment (DSRIP) funding pool from Texas’ Medicaid 1115 Transformation Waiver. In 2017, Texas received a new extension that continues that waiver through September 2022. However, DSRIP funding won’t be available starting in October 2021. 

“I think all of us wonder what’s coming next, but I also know we’re all thinking about this transition,”

Katie Coburn, director of regional healthcare partnership at Central Health, said. 
Central Health has a regional healthcare partnership with six counties in Central Texas. The organization works to provide access to quality care to low-income and underserved populations within these areas. 

“The 1115 waiver has really been a catalyst for innovation in care for this population,” Coburn said. “There have been a number of projects and new programs that have expanded access to innovative care to people who are low income who may not have had access to that previously.” 

The Southeast Health and Wellness Center, which was established by a collaborative effort involving Central Health, CommUnityCare, and the Southeast Austin community, has been able to provide preventative and other health services with help from DSRIP funding.  

“We provide a whole range of services to families there,” Coburn said. “Not just health services, but access to nutrition counseling, healthy education classes, Zumba, dance – really trying to attack those social drivers of health. It’s more than just providing care in a clinic, but providing a community where patients can feel at home and can get access to a range of services.” 

DSRIP funding also helps organizations with behavioral health services.

Health experts from Dell Medical School at The University of Texas at Austin held a legislative preview session at the Texas State Capitol to look ahead at what the state can do starting in 2019 when the legislature reconvenes. The Texas Health and Human Services Commission will have to submit a transition plan to federal health officials at the Centers for Medicare and Medicaid Services in October 2019, explaining how the state will continue delivery system reform efforts without relying on DSRIP in the future. 

“It’s not like Texas needs to know by then exactly what it wants to do, but we’re definitely hoping there will be some guidance this legislative session to begin to develop that plan,” Senior Policy Director Lisa Kirsch said. 

Kirsch said DSRIP has helped shape how providers approach delivering healthcare. 

“I’m hoping that local communities are going to come forward,” she said. “If people can get their primary and preventative care needs met, it’s better for their health. But in the long run, it’s cheaper for Texas, because then they don’t maybe develop conditions or land in the hospital where they’re going to have more serious complications and their health is just worse.” 

Coburn shares a similar sentiment. 

“If we can achieve health with the work we’re doing for patients, then we’re going to save long term as a community and people’s lives are going to be better,” Coburn said. 

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