Thursday, May 24 | Care Coordination, Human Services, EHR Solutions and Operations

Texas 1115 Waiver: Using Technology to Prove Outcomes

By Scott Green, Senior Vice President, CareGuidance

As payment models in healthcare continue to innovate and test new ways to lower costs and deliver quality outcomes, initiatives like the Texas Medicaid 1115 Waiver program become a vital route for organizations to maximize their Medicaid payments. The goal of the 1115 Waiver program is to allow Texas the ability to “expand Medicaid managed care, while preserving hospital funding. It also provides incentive payments for healthcare improvements and directs more funding to hospitals that serve a large number of uninsured patients.”

Local Mental Health Authorities (LMHAs) in Texas will be eligible to receive funding from a $25 billion bucket over the next five years if they can prove they have met or exceeded specific quality measures. Each quality measure is given a weighted score and each LMHA will have a minimum score to meet. Measures include screenings for clinical depression, body mass index, substance use disorders, medication compliance and chronic disease management.

So, how do organizations prove their outcomes yet remain efficient and maintain a high level of staff satisfaction? We talked with one of the largest LMHAs in the state, My Health My Resources of Tarrant County (MHMR) about how they are tackling the challenge.

“Part of our decision to implement the Netsmart system was their ability to accommodate the very specific requirements of the Texas 1115 Waiver program,” said Susan Garnett, CEO of MHMR. “The reporting requirements for proving outcomes can be a cumbersome one, especially if an organization doesn’t have an integrated EHR system. Netsmart is building the reporting directly into the workflows so it’s part of our process.”

In this day of bundles and outcomes-based payment models, basic automation from an electronic health record (EHR) just doesn’t cut it. Organizations need an integrated platform that gives them real-time access to information from across different providers and care settings, while providing insights and analytics that meet all outcome and regulatory requirements.

LMHAs in Texas have a tremendous opportunity to demonstrate results with the 1115 Waiver program by deploying connected, coordinated care models that lower costs for their organizations and improve outcomes for the individuals they serve.

“1115 is about healthcare transformation, soon we will have the technology to truly track our progress in serving people and supporting their health and wellness,” Garnett said.


About the Author

Scott Green, Senior Vice President / Managing Director, Care Dimensions

Scott Green leads the Care Dimensions business unit at Netsmart. He leads a team focused on building a comprehensive suite of solutions designed to support organizations as they digitize operations beyond the EHR. Green has been with Netsmart for 10 years and has held many roles during that time, including leading the Human Services business unit.

 

Meet the Author

Scott Green Blog Photo
Scott Green · Senior Vice President, CareGuidance

From the CareThreads Blog

Medi-Cal Enhancements and How Netsmart Can Help

Medi-Cal Enhancements for at-Risk Populations: What Does it Mean for Providers?

Friday, April 05 | Legislative/Policy,Care Coordination,Human Services

Two programs are at the forefront of behavioral health in California: Enhanced Care Management/Community Supports and CARE Court. These are significant advancements to Medi-Cal and are expected to yield improved care outcomes. What do providers need to know?

More

AI Before AI

Friday, March 29 | Thought Leadership,Cause Connected,EHR Solutions and Operations

As the healthcare industry propels into a new era of tech-enabled advancements, the conversation surrounding Artificial Intelligence shifts to an immediate focus on Augmented Intelligence, marking a pivotal moment in our journey toward transformative healthcare practices.

More
Celebrating individuals with intellectual and developmental disabilities

A World of Opportunities: Celebrating Developmental Disability Awareness Month

Friday, March 29 | Netsmart in the Community,Human Services

At Netsmart, we celebrate individuals with Intellectual and Developmental Disabilities all year, with technology to support person-centered care in a range of settings, using tools for community activities and helping individuals meet their self-determined goals.

More