TexHealth

05/15/2025

Join us for breakfast tacos and coffee at our free panel discussion! Seats are limited, so reserve your spot now.

02/06/2025

Corporate Ownership of Primary Care is Rising—But at What Cost?

A new study from Brown University School of Public Health highlights the increasing corporate ownership of primary care physicians, with nearly half affiliated with hospitals and a growing share tied to private equity firms. Analyzing data from major insurers, researchers found that hospital-affiliated physicians charge 10.7% more per office visit than independent doctors, while private equity-affiliated physicians charge 7.8% more. Despite these higher costs, there is no clear evidence of improved patient or physician outcomes. Researchers suggest that corporate consolidation in primary care is driven by demand for coordinated care and the ability to negotiate higher rates with insurers.

Some insight from our CEO, James (Jim) Rodriguez, LFACHE

This article reinforces my concerns about private equity’s role in healthcare and raises a red flag about hospital acquisitions of physician practices and their impact on costs. Office visit prices at hospital-affiliated primary care practices increased by 10.7%, while private equity-owned practices saw a 7.8% rise—without clear evidence of improved patient outcomes. In other words, we’re paying more without getting a better product. Physician buyouts are more common in northern states, while Florida and Texas lead in private equity affiliations. Interestingly, areas with more hospital acquisitions tend to have fewer private equity buyouts. What does that tell us? Let me know your thoughts.

To learn more about this concerning update, read the full article linked below.
https://lnkd.in/gWSxMGZy

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01/29/2025

Exciting TexHealth News 📢

Starting January 1, 2025, the income limit for employees of small businesses to qualify for health insurance assistance through TexHealth Central Texas will increase from $60,240 to $62,600 per year!

This annual adjustment is a great opportunity for client companies to review payroll and staffing to identify employees who may now qualify for the program. We’ve also notified our certified agents to help assess any groups they represent that could now meet the eligibility criteria.
Be sure to review these updates and take advantage of this chance to expand access to valuable health insurance assistance. Let’s make healthcare accessible for more Texans! 💙

To learn more about the TexHealth insurance assistance program, visit our website.
https://texhealthct.org/

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Empowering Texas Employers To Lower Healthcare Premiums and Promote Employee Health Join The Movement About Us We believe that everyone deserves access to quality healthcare, and we’re committed to making that a reality for the hardworking people of our community. Learn More https://texhealthct.or...

12/04/2024

Study Finds Lack of Health Insurance Drives Racial Disparities in Advanced Cancer Diagnoses

A new study by the American Cancer Society (ACS) reveals that lack of health insurance significantly contributes to racial and ethnic disparities in advanced-stage cancer diagnoses. Analyzing data from 1.9 million patients with 10 screenable cancers, researchers found that health insurance accounted for a substantial portion of disparities in late-stage diagnoses among non-Hispanic Black, Hispanic, and non-Hispanic Asian/Pacific Islander populations compared to non-Hispanic Whites. The findings highlight the importance of expanding health insurance access to reduce barriers to cancer prevention, early detection, and treatment, with ACS advocates urging policymakers to strengthen provisions of the Affordable Care Act to improve health equity and outcomes.

A Word From Our President:
It's disheartening to see so many people neglect their health for years. Early detection and preventive care are crucial for maintaining optimal well-being. Many individuals we encounter at TexHealth Central Texas haven't seen a doctor in years. Through their first well-visit, they've discovered underlying health issues that, if left unchecked, could have led to serious complications. Fortunately, they found TexHealth at the right time. Let's prioritize our health and encourage everyone to schedule regular check-ups. Remember, your health is your greatest asset!
Share the benefits of TexHealth Central Texas with your friends, family, and colleagues. Help us improve the health of our community.

To read the full article, visit the link below.
https://medicalxpress.com/news/2024-10-lack-health-coverage-disparities-advanced.html?utm_source=dailyinsurancereport.beehiiv.com&utm_medium=newsletter&utm_campaign=daily-industry-report-november-1&_bhlid=859984496d5dc5e2e8f8c3dcef40d2df30d8a479

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11/22/2024

🎉 Exciting News! 🎉

TexHealth is proud to announce the launch of our newly designed website! 🌟

Our refreshed platform is designed to make it easier than ever for small businesses and their employees to access the resources they need to thrive.

Our mission has always been clear: To provide access to affordable healthcare coverage and improved health outcomes for small employers and their employees within Texas.

The impact speaks for itself:
✅ 8,000+ Lives Impacted
✅ $9 Million+ in Non-Tax Subsidies reimbursed through our Premium Assistance Program
✅ 1,000+ Small Businesses Served
✅ Partnered with 60+ Insurance Agents

TexHealth is dedicated to creating a healthier Texas, one business at a time. Check out our redesigned website and see how we’re making a difference every day
https://texhealthct.org/

Additionally, please follow us on LinkedIn and Facebook, as well as share our link with any small business owners who might benefit from our premium subsidies.

Empowering Texas Employers To Lower Healthcare Premiums and Promote Employee Health Join The Movement About Us We believe that everyone deserves access to quality healthcare, and we’re committed to making that a reality for the hardworking people of our community. Learn More https://aom.tuq.myblue...

11/06/2024

Value-Based Care Advances Despite Financial, Data, and Engagement Challenges

At the recent NAACOS conference, healthcare leaders explored the ongoing shift to value-based care, which emphasizes patient outcomes and cost reduction. Leaders like Dr. Geoffrey Nicholson and Dr. Jamie Reedy noted that while this approach improves care quality, challenges remain in data integration, financial sustainability, and specialist engagement. Although private insurers have made strides with value-based agreements, aligning these models with specialty care remains complex. The COVID-19 pandemic highlighted the need for flexible payment structures, as many health systems rely on commercial payers to support government-funded programs. Moving forward, better data integration, patient education, and collaborative partnerships are essential for making value-based care successful and sustainable.

Comments from our CEO James (Jim) Rodriguez, FACHE:
“Having been through the advent of HMOs and the wars they created decades ago I know the hurtles that confront any change initiative, especially in healthcare delivery. However, value-based care is not unlike what has been done in the recent and not-so-recent past. But switching the risk from payor to provider has been especially prickly for some. The old adage thrown at payors of withholding care to save on cost will begin being used in the delivery field and many providers know that and dread that possibility. None, I’m sure would ever even consider that, but the dollar has a mesmerizing pull that even the most stalwart may fall victim to. Given these temptations there must be a way to share the risk so not one party (payor or provider) are left holding the proverbial bag. Sharing risk among the best and brightest minds will be fertile ground for gains in health and finances.”

Read the full article by Hayden E. Klein by clicking the link below.

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10/28/2024

Rising Insurance Premiums in 2025 Trace Back to Affordable Care Act's Unintended Consequences

Health insurance premiums are set to jump 7% in 2025, continuing a trend of rising costs that has frustrated consumers. Surprisingly, the roots of today’s escalating premiums can be traced back to the Affordable Care Act (ACA) of 2010. Despite its original goal of lowering healthcare expenses, the ACA triggered a wave of market consolidation, leading to fewer competitors and higher prices. Major insurers and healthcare systems have merged into powerful entities, making it easier to raise costs. To reverse this trend, the article by Forbes calls for a transparent, competitive healthcare model that ties pricing to quality outcomes.

Comments from our CEO James (Jim) Rodriguez, FACHE:

This is a very interesting article. I was surprised to read its claim that the ACA has to take responsibility for the high rate of health insurance and healthcare in general. I would like to say it’s not true because of the successes of the ACA but when I think about it, I see where the author is coming from. In the small group market in Texas there are only 2 fully insured small group carriers! (I wrote about this recently). They are United Healthcare and Blue Cross Blue Shield. Luckily in Central Texas there is also Baylor Scott & White and other regions have similar small players like them. Humana dropped out of small group, Cigna and Aetna don’t want small group and there is no ACA SHOP plans available in Texas. So, with so little competition it’s no wonder the rates are going so high. Combine that with the easily attainable cost sharing federal subsidies for individual coverage on the exchange, it’s no wonder rates are going up. While cost-sharing subsidies have helped many people afford coverage, they can also contribute to higher premiums. As insurers anticipate receiving more subsidy payments, they may increase premiums accordingly.

To read the full article by Forbes, check out the link below.
https://lnkd.in/e7V_iF73

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10/22/2024

⚡️Breaking News in the Health Insurance Industry ⚡️
4 nonprofit health systems have launched new health plan, Longitude Health

Comments from our CEO James (Jim) Rodriguez, FACHE:

Ok health insurance carriers…pay attention! Four (count them, FOUR) health systems have banded together to offer a new health plan called Longitude Health. The four owners, investors, operators are Baylor Scott & White Health, Memorial Hermann Health System, Novant Health and Providence. It appears that these delivery systems decided to take the plunge because of the carrier turmoil in their respective regions. For example, in Central Texas there are now only 2 major small group carriers with any real gravitas. They are United Healthcare and Blue Cross Blue Shield with Baylor Scott & White health plan trying to make inroads. And while the literature is shouting that rate increases for 2025 are going to be in the mid-single-digits we are seeing double digits across the board. This new entre may not bode well for the majors.

To read the full article by Modern Healthcare, visit the link below.
https://lnkd.in/g3EPYn5Y

02/22/2023

Here we are at another Legislative Session and we are going great guns! Our goal is to modify the statute that created TexHealth so that TexHealth does not have to have County Commissioners Court approval. When TexHealth was first created as a health plan for small business it made some sense for the County Commissioners to be involved in oversight. Now however, it is not needed and TexHealth should be available statewide to those who need the help paying for their health insurance premiums. We have proposed language to modify the original statute and we just need the Legislators to approve it. This will take visits to many offices to explain the rationale. If we are successful in getting the change we will also need more funding to go statewide. That is in the works too! Keep your fingers crossed.

09/10/2021

https://www.beckershospitalreview.com/payer-issues/metros-with-the-highest-uninsured-rates-by-state.html?origin=PayerE&utm_source=PayerE&utm_medium=email&utm_content=newsletter&oly_enc_id=7443D9880812F1R

The McAllen-Edinburg-Mission metro area in Texas has the highest uninsured rate at 35.7 percent when compared to other metro areas in the U.S., according to a ranking from 24/7 Wall St.

09/09/2021

https://www.informnny.com/abc50-now/lidocaine-solution-sold-in-the-u-s-recalled-could-lead-to-serious-complications/

UNITED STATES (WWTI) — Teligent Pharma, Inc. is voluntarily recalling one lot of Lidocaine HCl Topical Solution 4%, 50 milliliters which was sold in a screw cap glass bottle at the user level. The …

09/09/2021

https://www.beckershospitalreview.com/pharmacy/10-most-expensive-drugs-in-the-us-3.html?origin=CFOE&utm_source=CFOE&utm_medium=email&utm_content=newsletter&oly_enc_id=7443D9880812F1R

Spinal muscular atrophy treatment Zolgensma is the most expensive drug in the U.S., with a 12-month supply costing $2.1 million.