HHSC Releases Deloitte Report “State of Texas Medicaid Payment Reform”

consulting reportWednesday, TDMR received a notice that HHSC had put online a report from Deloitte Consulting LLP entitled, “State of Texas Medicaid Payment Reform – Market Assessment and Recommendation Analysis.” The report is dated March 31st, 2014 and is 51 pages long.  It is available online here.

The term “dental” only comes up ten times in the document.

As a Medicaid provider, the report might be of interest in how the DMOs will possibly be dealt with in the future by the State to reduce costs.  The aims of  CMS are “better health, better quality, lower cost.”

The following is from the Executive Summary:

As market pressures continue to mount, states are not only looking to derive more value from their managed care programs but also seeking to use these programs to address CMS’ Triple Aim: better health, better quality, and lower cost. In doing so, more states are seeking alternative methods to reduce costs while maintaining and/or improving quality. To gain an understanding of current payment reform programs around the country, the State of Texas asked Deloitte to conduct interviews with Medicaid managed care personnel from eight states to understand the nuances of their experiences rolling out payment reform programs. This report focuses on analyzing payment reform and value based purchasing initiatives in Texas and other targeted states, as well as performance measures needed to design and test alternative payment models.

There are a number of approaches the surveyed states have implemented or are considering:

    • Pay-for-performance Models,
    • Capitation Withholds,
    • Competitive Bidding,
    • Enrollment Processes,
    • Publishing Performance Data, and
    • Supplemental Programming.

Please see the actual report for the rest of the Executive Summary and Findings.

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