Abstract:
The expiration of the Texas 1115 Waiver at the end of September 2022 is a call to action. With the uncertainty surrounding the Texas 1115 Medicaid Waiver renewal, the state’s Health and Human Services Commission may consider some of the policy and regulatory changes to the Medicaid program that the Centers for Medicare and Medicaid Services (CMS) has been promoting, and that other states are working toward. This includes for example the transition to value-based contracting between health plans and providers. By understanding the context of policy trends, evaluating how other large states are preparing for an ever-growing shift toward value-based payment (VBP), and integrating lessons learned and progress achieved through its own DSRIP initiative, Texas can gain insight into how to approach its own waiver extension and/or renewal process. Hospitals stand to be especially impacted by what comes of the 1115 Waiver and must adapt to operate sustainably under new funding requirements.