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FOR IMMEDIATE RELEASE
November 04, 2004
Contact: James A. Cooley (512) 463-0630
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Delisi announces major savings on disease management initiative: $28.6 million to be saved, healthier Texans will be the result
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Temple – State Representative Dianne White Delisi announced today that she is very pleased with the news that Texas Health and Human Service Executive Commissioner Albert C. Hawkins has signed a letter of intent to begin the disease management initiative for Medicaid patients. Rep. Delisi was the author of the bill (HB 727) that created the Medicaid disease management program during the 78th regular session.
"The disease management model operates under the common sense principle that it is cheaper to keep patients healthier than to let them get progressively worse. We will either manage our health care expenditures or these expenses will manage us," Delisi stated. "We will save taxpayers $28.6 million over the current biennium and actually see these patient's lives improve along the way. Our savings come from the health improvements."
The state's new disease management program targets five chronic conditions that impact more than 55,000 Medicaid clients: asthma, diabetes, congestive heart failure, coronary artery disease, and chronic obstructive pulmonary disease. These five diseases represent the lion's share of total Medicaid spending and each of them can be better managed to help prevent the acute episodes and complications that drive up both costs and suffering.
"The savings to the state's general fund from this legislation over the biennium have now already exceeded the estimate in the bill's fiscal note by about $3 million," Delisi noted. "The other piece of good news is that even more savings and improved health outcomes will be realized as effective disease management is extended to those within the CHIP program and our own state employees. This is the next step in the disease management roll-out."
A two-page fact-sheet prepared by the Health and Human Service Commission on Disease Management is attached.
New Texas Disease Management Program for Chronically Ill Medicaid Clients
What is the Texas Medicaid Disease Management Program?
The Texas Medicaid Disease Management Program is new state program from the Texas Health and Human Services Commission that is designed to help improve the health and quality of life of Medicaid clients with chronic illnesses while reducing costs for the state.
Who will it affect?
The program will assist Medicaid Fee-for-Service beneficiaries with asthma, diabetes, heart failure, coronary artery disease and COPD (chronic obstructive pulmonary disease).
Number of Medicaid Clients Affected
More than 55,000 Medicaid clients are eligible. To identify clients, Texas Medicaid examined inpatient, outpatient and pharmacy claims data for condition or condition-related codes. Providers can also refer participants.
When will it begin?
November 2004
Benefits
Disease management can help improve the health and quality of life of Medicaid clients with chronic illnesses while reducing costs for the state. When a chronic disease is better managed, clients can experience less need for extended hospital stays, emergency department visits or use of other expensive medical services.
Cost Savings
Overall savings is estimated at 6% in costs associated with treating Medicaid fee-for-services clients with these diseases. A $28.6 million dollars savings to the state in the first year is estimated.
Who will operate the program?
The program will be administered by McKesson Health Solutions, a provider of care management and comprehensive disease management services by telephone for chronically ill patients in commercial and Medicaid populations.
How the Texas Disease Management Program will work
- Medicaid clients with a chronic illness can call toll-free to speak with a nurse any time they are sick, hurt or have a health question. The nurse will help clients decide whether they need to seek additional medical care or if the problem can be taken care of at home.
- The call center with nursing services will be available 24 hours a day/7 days a week to assist Medicaid clients with questions related to managing their diseases including changes in their health status or questions related to medication.
- Community-based registered nurses will operate in a collaborative effort with community providers and clinics. These nurses have expert knowledge and experience in specific disease processes and management skills to assist Medicaid clients on a face-to-face basis.
- Registered nurses work closely with the client’s existing physicians and treatment teams to assist in the implementation of the client’s treatment plan.
Philosophy
The program’s philosophy is to improve the client’s health status and quality of life by providing health resources and education that enable the client to better self-manage a chronic condition.
For additional information, contact:
Stephanie Goodman
Director of Communications
Texas Health and Human Services Commission
(512) 424-6951
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