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Section 1115 Medicaid Waiver

The Texas Health & Human Services Commission is implementing the Texas Healthcare Transformation and Quality Improvement Program: a five year Section 1115 Medicaid Waiver. The Waiver is designed to improve access to health care, the quality of care provided and contain costs.
 
The waiver is designed to meet several goals:

  • Expand risk-based managed care statewide.
  • Support the development and maintenance of a coordinated care delivery system.
  • Improve outcomes while containing cost growth.
  • Protect and leverage financing to improve and prepare the health care infrastructure to increase access to services.
  • Transition to quality based payment systems in managed care and in hospital payments.
  • Provide a mechanism for investments in delivery system reform including improved coordination in the current indigent care system in advance of health care reform.

Regional Healthcare Partnerships

There are 20 Regional Healthcare Partnerships (RHPs) located throughout the state. Parkland has been designated as the anchor facility for Region IX Regional Health Partnership (RHP). The region includes Dallas, Kaufmann and Denton counties.

The RHPs fund the state share of all waiver payments. All members of the RHP determine the menu of DSRIP projects and how funds will be distributed. Each IGT provider (ie public hospital or county) controls its own fund use and commitments. With few exceptions, providers and hospitals are a member of only 1 RHP. Some specialized providers (such as children’s hospitals) may participate in multiple regions, but must also have different DSRIP projects for those regions.

In Region IX, the Dallas / Ft. Worth Hospital Council has worked closely with Parkland and other participating entities to do a broad community assessment and create a menu of DSRIP options that meet the needs of the region.

Delivery System Reform Incentive Payments (DSRIP)

Hospitals may participate in the DSRIP program which rewards hospitals for achieving specific goals and improvements identified in their specific RGO. Each region’s plan identifies specific actions and timelines for achieving results in 4 categories. Each project that is undertaken must improve the Medicaid system, increase quality and contain cost.

Listed below are the 4 categories and the projects that Parkland will be focused:

  1. Category 1 – Infrastructure Development Improvement Projects
  2. Category 2 – Innovation and Redesign Improvement Projects
  3. Category 3 – Improvement in Quality and Safety
  4. Category 4 – Population Focused Improvements

For more information, please visit one of the following:

Texas Health & Human Services Transformation Waiver website
Overview of Texas Health Care Transformation and Quality Improvement Program: 1115 Waiver

For comments or questions, you may also contact us using the form below:

 

 

 

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