What is the Texas Medicaid Disease Management Program?
The Texas Medicaid Disease Management program is designed to help improve the health and quality of life of Medicaid clients with chronic conditions while reducing costs for the state. The program will assist Medicaid fee-for-service beneficiaries with asthma, diabetes, heart failure, coronary artery disease and chronic obstructive pulmonary disease. These five chronic conditions represent the “lion’s share” of total Medicaid spending in the state, according to state representative Dianne White Delisi, sponsor of the legislation creating the Texas initiative. To identify eligible clients, the Texas Medicaid agency (HHSC) examined inpatient, outpatient, and pharmacy claims data for condition or condition-related codes. Health care providers can also refer participants to the agency for program participation. How Does the Program Work? The program is administered by McKesson Health Solutions, a provider of care management and comprehensive disease management services. (It was awarded the
