HBA-EDN S.B. 283 77(R)    BILL ANALYSIS


Office of House Bill AnalysisS.B. 283
By: Nelson
Public Health
5/7/2001
Engrossed



BACKGROUND AND PURPOSE 

Healthcare for patients suffering from chronic disease consumes a majority
of all health expenditures.  In the managed care population, studies have
indicated that enrollees with chronic illnesses may consume more than sixty
percent of a group's healthcare costs.  Risk factors such as obesity and
lack of exercise are increasing among Texas' children, setting the stage
for an epidemic of chronic conditions such as diabetes and heart disease.
More children are experiencing chronic health problems than ever before;
for example, since 1980 the prevalence of asthma in the United States has
increased by 160 percent in children.  Recent reports suggest that many
patients with a chronic disease are not receiving the appropriate level of
care to effectively manage their conditions.  Contributing factors include
medication noncompliance, inadequate patient education and secondary
preventive services, unexplained clinical variation in treatment, and
inconsistency among physicians in following established treatment
recommendations.  Senate Bill 283 requires the Health and Human Services
Commission to study the benefits, costs, and effectiveness of applying
disease management principles in the delivery of Medicaid managed care
services. 

RULEMAKING AUTHORITY

It is the opinion of the Office of House Bill Analysis that this bill does
not expressly delegate any additional rulemaking authority to a state
officer, department, agency, or institution. 

ANALYSIS

Senate Bill 283 amends the Government Code to require, rather than
authorize, the Health and Human Services Commission (HHSC) to study the
benefits and costs of applying disease management principles in the
delivery of Medicaid managed care services to recipients with chronic
health conditions.  The bill requires HHSC, in conducting the study, to
evaluate the effectiveness of those principles in reducing longterm health
care costs under the Medicaid managed care program and in improving patient
care and utilization patterns of recipients.  The bill authorizes HHSC to
conduct the study in conjunction with an academic center.  The bill also
requires HHSC to ensure that managed care organizations under contract with
HHSC to provide health care services to recipients implement special
disease management programs to address chronic health conditions.  

EFFECTIVE DATE

September 1, 2001.