To support the NMDOH Subcommittee’s forthcoming recommendations to the 89th Legislature, the Texas Consortium for the Non-Medical Drivers of Health commissioned the Center for Health Care Strategies to develop this report, which presents state examples of MCO-led interventions related to: (1) food and nutrition; (2) CHW services; and (3) NMDOH case management for pregnant women, including social risk factor screening. It also outlines recommendations for HHSC to consider for alternative payment models (APMs) and coverage options to pay for and provide these NMDOH approaches.
Texas continues to make strides in addressing NMDOH. With support from the Episcopal Health Foundation, since 2019 the Texas Health and Human Services Commission (HHSC), Texas Association of Health Plans, Texas Association of Community Health Plans, and the Center for Health Care Strategies have convened the Managed Care Organization (MCO) NMDOH Learning Collaborative. The purpose of the learning collaborative is to promote effective strategies for addressing the non-medical needs of Medicaid beneficiaries and support the development and implementation of interventions to address NMDOH. Further, the learning collaborative provides critical input to HHSC with the development of NMDOH program and policy decisions. In 2023, the Texas Consortium for the Non-Medical Drivers of Health was established to bring together researchers, practitioners, and policymakers across the state to advance the incorporation of non-medical services into the health care delivery system in all state-supported health care programs.
In 2023, building on work by the learning collaborative, HHSC released the Non-Medical Drivers of Health Action Plan, a multi-pronged strategy and set of guiding priorities to drive NMDOH activities among MCOs and Medicaid providers, as well as other health care ecosystem stakeholders. The key NMDOH areas outlined in the Action Plan include food insecurity, housing, and transportation. The learning collaborative members also provided key inputs to HB 1575, signed by Governor Abbott in 2023, which requires HHSC to develop standardized screening questions related to non-medical needs and allows community health workers (CHWs) and doulas to become billable provider types under case management for Star Medicaid, HHSC’s children and pregnant women’s program.
About This Report
With support from the Texas Consortium for the Non-Medical Drivers of Health, hosted by the Baker Institute for Public Policy at Rice University and the Episcopal Health Foundation, the Center for Health Care Strategies developed this report to summarize evidence and implementation options for food interventions and community health worker programs, NMDOH perinatal programs, and alternative payments options to support these efforts. Thie report provides additional background and context for the Texas Value-Based Payment & Quality Improvement Advisory Committee’s recommendations for the 89th Legislature.
