Reports and Presentations

A study to assess the impact of revising the capitation rate setting strategy used to cover long-term care services and supports provided to members enrolled in the STAR+PLUS Medicaid managed care program, from a strategy based on the setting in which services are provided to a strategy based on a blended rate across settings.

The Texas Health and Human Services Commission (HHSC) assessed the feasibility of creating an online portal for individuals to both request and check placement on a Medicaid waiver program interest list. Through this study, HHSC determined the most cost-effective automated method for determining the level of need of an individual seeking services.

The supplemental report builds on the information provided in the September 2022 Dually Eligible Individuals Enrolled in Medicaid Managed Care report and provides HHSC’s findings regarding the cost-effectiveness of transitioning Medicaid-only services for dually eligible people into Medicaid managed care and requiring cost-sharing for those services, considerations of the costs associated with the operational and systematic changes needed to implement the transition and a recommendation as to whether the transition and cost-sharing should be implemented.