Dear Members,
On January 14, TAHC&H staff attended the United Healthcare (UHC) Statewide Association Advisory Committee meeting, where the MCO described the recent restructuring of its leadership, designating two CEOs for the state of Texas: Marian Cabanillas for South Texas, and Jeff Maddox for the northern portion of the state. Ms. Cabanillas has oversight of the STAR+PLUS and STAR Kids programs for UHC.
Ms. Cabanillas provided an update on UHC's activities related to HHSC's LTSS re-enrollment deadline of February 1, 2019, noting that they still have 190 providers under contract who have not yet completed this enrollment with the state. UHC will have to move the clients served by these providers to other, enrolled providers as of February 1. The MCO has put out several notices reminding providers to enroll as soon as possible.
UHC is currently researching the utilization of therapy services in their programs, as well, after finding that the cost per member per month in Texas ($21) is much higher than in other states ($6/pmpm in Florida, for example). UHC states that they are committed to ensuring that members who need these services are receiving them, and will continue to review the issue.
UHC’s Medical Director, Dr. Salil Deshpande, gave an update on a new access-to-care initiative they are preparing to implement in the western part of Houston. This area was identified by UHC as an underserved part of the city, and in order to provide better access to care for UHC members and some uninsured members of the community, the MCO is opening a Neighborhood Clinic to serve both children and adults. This clinic will be open to UHC members, as well as uninsured clients who come in seeking care (these clients will pay a flat rate for services). UHC hopes this facility will help bridge the gaps for clients who have been unable to find a PCP close to them, offering evening and weekend hours for convenience. The health plan will share more information on this opportunity in the near future.
Also of note, United Healthcare is developing an incentive program for home health providers during calendar year 2019, which it hopes to offer for therapy, personal assistance services (PAS) and private duty nursing (PDN). These programs are still being developed and refined; we look forward to hearing more about them in the spring.
Thank you!