Will Health Insurance In Texas Offer Better Patient Outcomes With Legislative Changes?

The Texas legislature is taking progressive action to focus health care on quality with two Senate bills. Senator Jane Nelson hopes to build incentives for keeping patients healthy into the health care payment system. This legislation would pay health care providers based on the quality of care they provide.

While that sounds like a commonsense idea, the present system is very different. Regardless of the outcome for the patient or the cost of procedures, the system now pays based on the number of procedures performed.

In this scenario, profit depends on how many tests are done and it is not tied to whether the procedures produce any benefit for the patient. While changing this system may be ambitious, the outcome could give you more for the money you spend on health insurance in Texas.

Texas Health Insurance Out-of-pocket Costs Could Be Reduced

Many people who have switched to Texas health insurance plans with deductibles of over $1,000 would save on out-of-pocket costs if duplicative or even unnecessary tests were reduced. Moving pay incentives away from running tests toward preventing health problems would not only save patients money, but could also save them a lot of trouble.

It sounds like an intelligent short cut to eliminate waste and, hopefully, reduce the number of unpleasant procedures patients are subjected to that don't contribute to the their well being, doesn't it? Could it also help to lower premiums on health insurance for Texas?

Senator Nelson is adamant that, "We shouldn't be rewarding the greater number of tests and treatments you get. We need to remember that those payments come from either the premiums that we pay as individuals or entitlement programs in our tax dollars. Those dollars should reward healthy outcomes."

Texas Health Insurance Value Stands To Increase With Improved Health Care

Lt. Gov. Dewhurst emphasizes that, "In Texas, we don't have health care - we have sick care. America, almost exclusively, pays doctors based on how many procedures are done, versus paying for good medical outcomes and paying for following best practices." Best practices have been shown to dramatically improve patient outcomes even when simple guidelines have been followed.

At least one pilot project is already showing rewards and passing savings back to the patients. A Medicare pilot project at San Antonio's Baptist Health System has cut the expense of certain orthopedic and heart procedures. The hospital, the surgeons and approximately 2,000 patients have shared in the savings. The federal government is also involved in monitoring the quality of care provided.

The senior V.P. of the Baptist system says, "As a result of this innovative approach, we have been able to lower the cost of care by millions of dollars since the program's inception." Zucker applauds this outcome as a win-win situation for everyone involved.

Senator Nelson promises that the legislation will move Texas "toward a payment system that rewards quality outcomes rather than quantity of services." She says, "I guarantee you, it's not only going to save us money, it will improve [healthcare] and we'll have healthier Texans." Rep. Lois Kolkhorst is expected to introduce a companion bill in the House.


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By Wiley Long - President, eTXHealthinsurance.com - Texas's leading independent online health insurance agency specializing in individual and family Texas Health Insurance plans. Get an online Health Insurance quote, compare plans, apply online, and Save!