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Central Health Votes to Create HMO

The Central Health Board of Managers on Thursday approved the formation of a Central Health funded health management organization (HMO).

The board’s motivation for approving this program is to better manage and coordinate the healthcare needs of the populations Central Health serves. State and local dollars will be leveraged to upgrade the current systems for healthcare service delivery coordination and care management, which can then be used for members of the HMO, for Medical Assistance Program (MAP) patients and others. It is also an opportunity to generate and diversify Central Health’s revenue base, the surplus of which can be reinvested for improvements of central Texas’s local healthcare system.

Several other Texas hospital districts have created successful HMOs, including Parkland Community Health Plan in Dallas, Community First Health Plans in San Antonio, Community Health Choice in Houston and El Paso First Health Plan. Only one metro HMO, MetroWest Health Plan in Fort Worth, has been dissolved, due to strategic redirection issued by its board. Based on more than a year’s worth of research and study, we believe we have the infrastructure, know-how and resolve to create a successful plan that provides an efficient program of care for its enrollees,” Central Health President and CEO Patricia A Young Brown said.

One of the most significant assets this new HMO will provide is the creation of a more seamless system of healthcare delivery. Rather than maintain separate systems for different populations, the new HMO will allow for a more efficient system of integrated care. As patients within the system frequently move in and out of coverage or across various levels of coverage depending upon their financial situations, consistent, quality care will be available. A common network of partnered providers, and the combination of MAP and HMO enrollees will extend Central Health’s negotiating power to ensure a more significant number of providers willing to accept those patients.

The creation of this HMO comes partially as the result of the Health and Human Services Commission (HHSC) proposing an expanded program to allow delivery of Medicaid services through HMOs statewide in 2011. In conjunction with anticipated changes to the healthcare delivery system pursuant to the Federal Affordable Care Act, this new HMO will provide access and care to a population of individuals who otherwise would still remain without resources to obtain health insurance or find access to care.