Regional Healthcare Partnerships: Roles & Responsibilities Overview


Regional Healthcare Partnerships are locally-developed confederations that fund the state share of all waiver payments in a partnership. Counties and other entities providing state share will determine how their funds are used in the Regional Healthcare Partnership consistent with waiver requirements. Each Intergovernmental Transfer (IGT) provider controls its own fund use and commitments, provided that participating health-care providers that may be affiliated with the transferring entity adequately document levels of uncompensated care or meet required performance goals. 

Regional Healthcare Partnerships create a regional plan as the basis for:

  • Voluntarily improving regional access, quality, cost-effectiveness and collaboration. 
  • Identifying transformation programs, performance metrics, and incentive payments for each participating hospital consistent with the Delivery System Reform Incentive Payment (DSRIP) menu of projects.
  • Payment of funds (formerly Upper Payment Limit funding) protected under the Texas Healthcare Transformation and Quality Improvement Program 1115 waiver.

The Texas Health and Human Services Commission’s approach for Regional Healthcare Partnership development is to provide waiver information, including requirements and opportunities for stakeholder involvement, and allow local communities to propose local partners and areas covered.  HHSC’s direct facilitation in Regional Healthcare Partnership development will increase as needed to support development of partnerships under the waiver.

Regional Healthcare Partnership Principles  

Regional Healthcare Partnership should promote system transformation (improved access, quality, cost-effectiveness, and coordination).

Delivery systems should be developed based on geographic proximity and an ability to efficiently deliver care to regional residents.  Specialized providers (such as children’s hospitals, trauma hospitals, burn centers, etc.) can and should be included based on delivery system functional needs, even it is outside the area’s geographical boundaries.

Regional Healthcare Partnership and resulting plans should reflect broad inclusion of local stakeholder engagement, including:

  • County medical associations/societies
  • Local government partners
  • Children’s hospitals
  • Academic health science centers
  • Department of State Health Services regional public health directors
  • Hospitals with significant Medicaid utilization

Each Regional Healthcare Partnership must identify an anchoring entity, which is the lead health-care provider or local government entity that serves as the primary liaison between the RHP and HHSC, and coordinates planning, activities, and reporting among all partnership participants.

In general, an intergovernmental transfer (IGT) provider or other hospital should participate in only one Regional Healthcare Partnership even though some hospitals will be in areas near more than one partnership.  Specialized providers (such as children’s hospitals) may provide services to more than one partnership.  However, hospitals participating in more than one Regional Healthcare Partnership may not be paid for the same project in various partnerships.

Regional Healthcare Partnership roles and responsibilities will likely evolve, and the information provided here should act as general guidelines rather than final determinations. 

Roles and Responsibilities Matrix (DOC)