Opinions Mixed as Managed Care Comes to Valley

Texas Tribune – by Holly Heinrich 2/21/2012.

Managed health care services, which had been the subject of a recent moratorium in three Rio Grande Valley counties, will soon be available for Medicaid patients in those counties and the rest of the Valley.

On March 1, Medicaid patients living in what the Texas Health and Human Services Commission classifies as the Hidalgo Service Area will be eligible for the services, in which private organizations receive set monthly payments from the state to provide health services for patients. The Hidalgo Service Area includes Starr, Duval, Jim Hogg, McMullen, Webb, Willacy and Zapata counties, as well as Hidalgo, Cameron and Maverick counties, which had previously banned managed care.

graphic by: Todd Wiseman

Advocates of managed health care say the program has proven to be cost-effective in parts of the state where it has been implemented. But others say that managed care will not meet the unique needs of the Valley.

As Texas Monthly reported in December 2009, a group of South Texas legislators called for the moratorium in 2003, led by then-state Rep. Ismael “Kino” Flores, D-Palmview. The lawmakers said unique conditions made the Valley unsuitable for managed care, citing the region’s high rate of chronic, expensive-to-treat illnesses such as diabetes, and also said managed care would put economic pressure on the Valley’s already scarce physicians. Read Full Article