Region 3 Sustainability Planning Needs
Through spring and summer 2017, you'll be invited to participate in webinars providing training and education on how to sustain DSRIP services.  Along with the Anchor, two committees of your peers are identifying what Providers want to know about sustaining projects. 

In fact, we used a live polling survey at the February 7, 2017 Learning Collaborative to gain insight into this.   

The chart on the right displays the survey's results (a review of the event and the full survey results are here ), demonstrating that the Region requests the most assistance in developing funding stability, partnerships, and program evaluations.  

Watch the short video below for information about the webinars the committees are hosting to support Providers in these areas.  We hope you'll join us!
RHP3 Webinar Series
Healthcare: Coverage Expansion and 1115 Waivers
 
As Texas approaches the anticipated third iteration of the 1115 Waiver, we're mulling over the ongoing changes to Texas' DSRIP program, its sustainability, and the impact coverage expansion would have on it.

Since its implementation in 2011, Texas' 1115 Waiver has provided substantial federal funds to expand access to healthcare for uninsured and Medicaid patients. Policy changes and judicial rulings since have impacted the healthcare funding environment, creating unexpected challenges including the absence of coverage expansion. Finding ways to cover healthcare costs for millions of currently uninsured Texans, and the short term nature of the Waiver, has made sustaining services and access provided via DSRIP an even more pressing issue. In fact, a recent survey of Region 3 DSRIP Providers showed that eighty percent of respondents were unsure of the future of their projects due to lack of funding sources outside of DSRIP. 

In a future scenario in which the 1115 Waiver does not directly fund current DSRIP services, coverage expansion would provide stability. In fact, 1115 Waivers have been used to create innovative coverage expansion models in seven states:  Arizona, Arkansas, Iowa, Indiana, Michigan, Montana, and New Hampshire. These waivers allow states flexibility to implement state-specific concepts like Medicaid premium contributions. If Texas sought to use the 1115 Waiver to expand allowable coverage in the future, it could support a different service delivery reimbursement structure, potentially aligned with the quality-based direction of capitated Medicaid managed care which HHSC is shifting DSRIP toward already.

Shifting the 1115 Waiver's objective to expanding allowable coverage could mitigate concerns about project sustainability and providers' ability to continue serving vulnerable patients.  Still, substantial questions remain:  What legislative tool could be used to expand coverage in Texas? How would Texas fund it?  And does Texas want to take this approach?  Answers to these depend on interrelated federal, state, and local policy choices spanning our complex healthcare finance environment.