Austin –State Representative Dianne White Delisi today announced the filing of legislation (HB 1771) to create a new model in health care for Texas' Medicaid patients. The bill calls for a pilot program on Integrated Care Management, an emerging model of care that functions as somewhat of a hybrid between Primary Care Case Management (PCCM) and a Health Maintenance Organization (HMO).

"This bill will take the doctor-centered approach of PCCM and add in, among other improvements, an overlay of the medical information management available in an HMO," Delisi stated. "This is an attempt to get to the best of both worlds through an approach that uses the strongest features from both models."

Delisi said she has been looking into the idea of a new medical model for some time. The recent concerns over the looming loss of federal Upper Payment Limit funds to urban hospitals under a full Medicaid HMO system spurred her to offer this new option.

"Too much of what we face now is the trap of the "either/or" scenario," Delisi said. "We don’t have to do it that way. We have an opportunity to design a Medicaid patient treatment model that works for the patients, doctors, hospitals, local governments, and taxpayers. Better yet, it can actually maximize access to federal funds."

Delisi's bill calls for a pilot program to be conducted in eight areas of the state and cover both urban and rural locations. This new system must keep the doctor in charge of health care decisions, but will also provide these physicians with access to the technological tools they need to truly manage patient care. The bill also calls for each patient to have a medical home, the performance of a medical screening of new patients, the use of evidence-based treatment protocols to guide treatment decisions, and the use of a comprehensive system of quality management.

"We have a chance to do something new in health care," Delisi concluded. "I am really looking forward to discussing this bill with my colleagues."