Last week, the state Senate unanimously passed a bill that would change payment rates for Medicaid and the State Child Health Insurance Program from procedure-based to performance-based. The purported goal is to raise quality of care while reducing costs. An excerpt:
That bill also gives the Health and Human Services Commission the authority to try out various performance-based payment models through pilot programs. One potential pilot program, which already has raised some antitrust concerns, would allow doctors and hospitals to collaborate to provide more comprehensive care. HHSC could use alternatives like bundled or quality-based payments to reimburse providers for collaborative care.
Each collaborative would be required to pay the Texas Department of Insurance a fee to register, which the fiscal note states would cover the cost of hiring 13 new employees to develop regulations to ensure they don’t violate antitrust laws.