Big Win for Texas HHSC Receives Extension for Medicare and Medicaid

AUSTIN – The Health and Human Services Commission and the Centers for Medicare and Medicaid Services have agreed to extend a state and federal partnership that finds innovative ways to deliver healthcare.

The 1115 Waiver, which funds Uncompensated Care and the Delivery System Reform Incentive Payment Program (DSRIP), was extended 15 months under an agreement between the health agency and CMS. The agreement will take the program through December 2017 and will maintain its current funding.

“We’re pleased these innovative programs will have the opportunity to continue,” HHS Executive Commissioner Chris Traylor said. “These programs are improving health care for Texas’ Medicaid clients and creating cost-savings for taxpayers.”

Over the next 15 months, HHSC and CMS, which oversees the Medicaid program, will continue negotiating a longer term extension.

DSRIP consists of local programs working to improve health care delivery costs and outcomes.

There are 1,451 DSRIP projects across 20 regions in the state. In each region a coalition of governments, hospitals and other providers are charged with coming up with novel solutions to containing health care costs while preserving access and quality. Most projects focus on increasing primary and preventative care, which not only improves outcomes, but saves money by reducing the need for expensive emergency room visits. The waiver program also helps hospitals with uncompensated care costs.

One program in Travis County trains paramedics to visit people who have frequent emergency room visits. The program has found some people can’t treat conditions such as diabetes because they don’t have a ride to pick up the materials. Helping prevent serious episodes is healthier and cheaper than an emergency room visit.

“One of the things I like best about these projects is they use the knowledge of the people on the ground to identify their problems,” Commissioner Traylor said. “Beaumont faces different issues than El Paso and the waiver program takes advantage of local expertise.”

The Uncompensated Care program and Delivery System Reform Incentive Payment programs are funded through a combination of federal and local money. Both Uncompensated Care and DSRIP contribute $3.1 billion a year, each.