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Texas Health Care Reform: Navigating Challenges and Innovations

This report outlines the current state of the Texas health care system as of September 2007, highlighting key components such as employer-based insurance, public programs, and the uninsured population. It identifies primary challenges, including access, affordability, and fragmentation, and discusses specific Texas challenges like demographics and regulatory frameworks. The report also reviews recent legislative activities, including Senate Bills aimed at reforming Medicaid and enhancing price transparency, while presenting considerations for future health system reform focused on quality, safety, and consumer empowerment.

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Texas Health Care Reform: Navigating Challenges and Innovations

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  1. Texas Health Care Reform Coverage Institute September 26, 2007

  2. The Texas Health Care System • Employer-based health insurance (~50%) • Non-group (No guaranteed issue, full medical underwriting & pre-existing condition exclusions allowed) • Small group (guaranteed issue & renewability, limited medical underwriting & allowed) • Large group (limited rate/underwriting regulation) • Public programs (~25%) • Medicaid (~12%, 2.8M) • Uninsured (~25%)

  3. Primary Challenges • National Challenges • Access • Affordability • Costs • Fragmentation (horizontal) • Texas-specific Challenges • Demographics • Industry structure • Fragmentation (vertical) • Regulation

  4. Framework for Reform • Health Care Delivery • Risk & Cost Distribution • Patient & Consumer Dynamics

  5. Sample of Recent Activities • Health Care Delivery • House Bill 1066 (health information technology) • Risk & Cost Distribution • Senate Bill 10 (Medicaid reform) • Patient & Consumer Dynamics • Senate Bill 1731 (Price & quality transparency)

  6. Considerations for Texas Health System Reform • Health Care Delivery • Regulatory review • Aligned incentives for quality, safety, and efficiency • Risk & Cost Distribution • Health insurance market reform • Health insurance market support • Health insurance market infrastructure • System integration • Eligibility changes • Patient & Consumer Dynamics • Personal responsibility • Consumer empowerment

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