Photo by Cathy Chedrawi

Williamson County is collaborating with other counties, local governments and health care providers to create a regional health care partnership. Some of the potential partners met in Waco at Providence Health Center on March 20 to discuss the program.

In December 2011, the Centers for Medicare and Medicaid Services approved the Texas Healthcare Transformation and Quality Improvement Program 1115 Waiver, which aims to improve the Medicaid system in the state and make it more cost-effective.

"It's basically driven to try to transform the Medicaid system and how we deliver that in Texas," said Cynthia Long, Willamson County Precinct 2 commissioner, at a March 6 regular Commissioners Court meeting. "And the waiver was granted to try to give us the ability to kind of creatively do that at the local level."

Bride Roberts, accreditation coordinator with the Williamson County and Cities Health District, said the change makes up to $29 billion in federal matching funds available to Texas over five years. Under the old model, the funds would have been no more than $15 billion, Roberts said.

The matching funds come from two pools. One is the uncompensated care funds, which are similar to the current Upper Payment Limit Program, a supplemental payment to hospitals taking care of Medicaid patients. Money can also come through Delivery System Reform Incentive Payments, which are funds that will go to hospitals developing programs and strategies to enhance access to health care as well as increase health care quality and cost-effectiveness.

To access the funds, counties, local governments and health care providers have to organize into regional health care partnerships. The partners can then submit plans for improving programs and addressing needs found in a regional health assessment.

"We have to propose for the next four years, benchmarks, metrics that we would hope to attain with those programs, and if we meet those benchmarks, we'll get paid for it," Roberts said. "There's the potential to draw down significant dollars to help us grow those programs."

As a part of the program, every county in Texas has to be in a region, but participating financially is optional, Long said. Commissioners approved a proposed list of counties to go in a region with Williamson County on March 6 that included Burnet, Llano, Milam and other northern counties.

The proposed region map at the March 20 meeting included 17 counties, but Roberts said the map could change if counties elect to go in other regions.

Williamson County Commissioners recommended March 6 at their regular meeting that the Texas A&M University Health Science Center in Round Rock serve as the anchor, or facilitator, for the region. Roberts said the anchor will perform tasks such as reporting to the Health and Human Services Commission, convening meetings, reporting out the matching funds and making sure that the funds are distributed.

"Everybody who provides health care services in the region has a stake in this," Roberts said. "It's going to be important for everybody in the region to pull together to identify the projects and agree upon how to implement this."

In August, the RHPs must report to HHSC what the incentive plans are for improving and expanding health care in the region.