TCCRI Health Care Summit Review
I recently participated on a panel with Senator Kelly Hancock, Representative James Frank, and representatives from Teledoc, the Cicero Institute, and the Texas Association of Health Plans at the Texas Conservative Coalition Research Institute’s (TCCRI) Health Care Policy Summit. Our panel touched on many issues related to access, affordability, and transparency in health care. Here are the key takeaways from the panel discussion:
Advanced Practice Registered Nurses- In Texas, APRNs are only allowed to practice to their full extent of their training and license under the delegation of a doctor. This has created a “tax,” as our panel moderator described, on this profession. What does this mean? If an APRN would like to independently practice, they must pay their delegating doctor sometimes tens of thousands of dollars to read a few charts and have a few phone calls each year.
APRNs are an integral part of our health care system and could help fill care gaps in rural and underserved communities in Texas, especially in primary and mental health care. Instead, many APRNs are choosing to practice in neighboring states because of Texas’ restrictive laws. We are losing our best and brightest nursing professionals and continue to have 6,000,000 Texans living in Health Professional Shortage Areas.
As we move into next session, TAHC will continue to work with a large coalition of parties who are part of Texans for Health Care Access interested in lifting delegation requirements for APRNs. https://www.texans4healthcareaccess.org/
Telemedicine- Telemedicine was quite literally lifesaving during COVID. While usage numbers have leveled off, its value remains high, especially in the mental health conversation. For example, Senator Hancock, who just two years ago had a kidney transplant and was incredibly immune suppressed during the long recovery period, was much better served using telehealth as opposed to risking his immune system through in person, crowed waiting room appointments.
Continuing to see the value and lessening restrictions on tele-medicine will go a long way to further increase access to medical providers for Texans. TAHC will always advocate for increasing access to health care.
Facility Fees and Billing Transparency- With the rapid consolidation and private equity takeovers of the health care industry, patients are seeing additional fees charged for simply stepping into a doctor’s office. These are called facility fees and Chairman James Frank filed a bill last session to stop the charging of these fees in certain situations.
More work will be done this session to address this issue. A step in the right direction would be the prohibition of facility fee charges for primary care visits and telemedicine visits. Having accurate data regarding where the health care services occurred (primary care doctor’s office v. hospital emergency room, could also prove to be helpful in billing transparency and appropriate facility fee charges.
On the panel we also discussed whether current billing transparency laws are working. The consensus was that these laws were moving things in the right direction, but more work needs to be done for Texas patients.
I pointed out that a recent hospital bill I received simply had an amount owed with zero explanation of why. We believe at TAHC that just like any other industry, patients should receive a detailed bill after a hospital visit and should not have to chase down a detailed invoice.
Mandates- The last topic we discussed is the rapid increase in health care mandates on Texas plans. These mandates, while often well intentioned, have earned Texas 3rd place in the nation for the highest number of required covered mandates. Health care costs increased by 13% last year and we are on track for another 6%+ increase in the coming year. This is not sustainable nor helping Texas’ uninsured populations. TAHC supported and will continue to support two proposals from last legislative session.
The first would allow employers to offer health coverage to their employees without including Texas mandates. This could provide a more affordable option for employers who may currently be choosing to not offer health coverage at all. It would also create competition in the marketplace by introducing a new coverage option.
The last policy change that could go a long way in cost transparency is to require that a cost analysis be done on every health care mandate proposed by the Texas Legislature. By knowing and understanding the costs on the front end, perhaps legislators might pause before passing mandates that continue to cause health insurance premiums to ballon.
With the help of our over 30,000 advocates TAHC will explore and support common sense reforms in the health care space that increase access, affordability, and transparency for all Texans. We look forward to more lively discussions on these issues throughout 2024!