Healthcare

A high quality health care system is important to our business community and our residents. Texas continues to rank #1 in the number of uninsured and our state's health care costs continue to rise at an unsustainable rate. The implementation of Federal Health Care Reform is underway and more consumers will be entering our already stressed healthcare system.

"Do No Harm" While Leveraging Federal Funds

CHIP and Medicaid Cuts: The Austin Chamber opposes any cuts to CHIP and Medicaid. The State of Texas should not cut state expenditures for these programs which, in reality, shift the burden of those costs to local businesses, taxpayers, and providers. Furthermore, because both CHIP and Medicaid are in-part funded with matching federal funds, a reduction of State funds would also mean a reduction in these matching funds, effectively guaranteeing that fewer of Texas's federal taxpayer dollars will come back to the State (for every $1 Texas cuts in State funding for Medicaid, the State loses approximately $1.42 in federal monies).

To "Do No Harm", the Texas Legislature should also consider the following:

Physician and Provider Reimbursements: The Austin Chamber opposes reducing the already low rate of provider reimbursements. Such a reduction will have its greatest impact on urban areas and will not only affect the availability of care for our patients now; it will also reduce the number of providers that will be available to Texas residents in the future.

Multi-Share Programs: Multi-share, or 3-Share Programs, are important healthcare funding mechanisms for Texas because they create opportunities to enhance benefits and/or reduce employer and employee health care costs by splitting the financial responsibility for providing health care with a third payer – public or philanthropic funding sources. These programs first begun in Texas in July of 2008, show great potential and should be allowed to mature to ensure they fully evolve into vital healthcare funding alternatives for the State.

Funding Mechanisms that Address the Uninsured: The Austin Chamber encourages maintaining the integrity of current funding mechanisms for healthcare that address the uninsured such as disproportionate share dollars (DSH) and upper payment limit (UPL) funding, particularly throughout the process of structuring and implementing health care reform as some individuals will not be eligible to participate in the state exchange program.

Prevention Mechanisms

The Austin Chamber believes the health of Texans would improve with the Legislature's support of incentive-based strategies and programs to promote wellness and prevention with an emphasis on tobacco cessation, obesity, diabetes, immunizations, and mental health.

Medical Home Development

The Austin Chamber supports the implementation of the "medical home" concept, also known as "integrated care", to improve the quality of healthcare, increase efficiency, and reduce costs. Successful administration will require support for an educational component designed to redefine conceptions of care for both physicians and patients. Additionally, integration of healthcare should be incentivized for both physical and mental health services.

Tort Reform

The Austin Chamber will oppose any legislative efforts to make substantive changes to the advances Texas has made in civil justice reform, which have led to vast improvement in the overall economic climate, particularly the healthcare industry. Specifically pertaining to healthcare, we urge the legislature to maintain current cap levels.

Trauma Care

The Austin Chamber urges the distribution of all the uncompensated trauma and emergency health care designated account funds to designated trauma centers in a timely and appropriate manner.

Healthcare Professional Shortages

The Austin Chamber supports maintaining, restoring, and diversifying the funding sources and strategies employed by the State for addressing the shortage of healthcare professionals, particularly through the support for a variety of training opportunities at all levels of provider care and the authorization of financing solutions for healthcare education cost management.

• Educational Opportunities: We support a manifold package of funding mechanisms and opportunities for provider training at all levels including the continued funding of academic medicine, the restoration of Medicaid Graduate Medical Education payments for hospitals, the recruitment and retention of additional qualified faculty, and the creation of new faculty positions.
• Education Costs: The Austin Chamber supports financial strategies that incentivize educational attainment including educational loan repayment programs, deferment of educational loans during medical residency and internships, and grants for scholarships.

Mental Health

The devastating impact of mental illness on Texas employers, their employees, and the economic health of our State threatens to impede our very basic ability to be competitive nationally and on a global scale. Indirect costs of mental illness alone are astounding: in Texas, the figure is estimated at $16.6 billion with a 'real' fiscal impact on state and local governments of $1.5 billion, without accounting for incarceration, homelessness, and early mortality.

Despite very real negative fiscal implications and the demonstrated hindrance to our intellectual output and individual life achievement, mental health services have always been and continue to be deeply underfunded, particularly in comparison to other health services. The grave disparity of investment is acutely evident in our struggling mental health infrastructure which is unable to meet the considerable need and is already hemorrhaging human capital.

The Austin Chamber strongly opposes cutting funding for mental health centers. The State of Texas must carefully protect existing mental healthcare resources and not handicap a system that is already desperately burdened.

Cancer Prevention and Research Institute of Texas (CPRIT)

The Austin Chamber continues to support funding for the Cancer Prevention and Research Institute of Texas (CPRIT), which is vital to keeping Texas at the forefront of innovation and developing a robust and cutting-edge research community in the State.

Health Information Exchanges (HIE) and Health Information Technology (HIT)

The Austin Chamber fully supports the engagement of the business community in the consensus-based stakeholder decision-making inherent in the design of Texas' governance structure for coordinating the implementation of Health Information Exchanges (HIE) and Health Information Technology (HIT) in the State. However, success of this model and the Texas Health Services Authority (THSA), the public-private collaborative created by HB1600 in 2007, is highly depending on this HIE governance entity achieving a level of operational maturity that takes advantage of this mechanism for negotiating health IT and HIE solutions among diverse interests to drive HIE developments.

The Austin Chamber supports THSA significantly prioritizing the robust multi-sector, multi-stakeholder participation required for effective statewide HIE governance, the optimization of resources allocation, and the creation of the accountability, policy and technical frameworks vital to the sustainability of HIE deployment.

The Austin Chamber advocates for the Texas Health Services Authority and appropriate state agencies to develop a statewide health information exchange strategy that integrates with existing electronic health record and health information exchange infrastructure developed by local communities.

Expedite Medicare EMR Incentive Programs to Secure the Greatest Amount of Decreasingly Available Federal Resources

While ARRA stimulus grant funding under the HITECH Act has largely been awarded to other states, Texas still has an opportunity to maximize federal resources authorized by the Act which provides 100% federal funding for Medicaid meaningful use incentive programs and 90% for reasonable state administrative expenses. The Austin Chamber strongly encourages the THSA to follow the recommendations of the Centers for Medicare and Medicaid Services by implementing Texas Medicaid EHR inventive programs as soon as possible in 2011 to maximize the State's access to available federal resources include time-limited funding and technical assistance.

Federal Healthcare Reform

The Austin Chamber strongly supports a deliberate process for State implementation of Federal Health Care Reform. It is imperative that the State prepare for the implementation of health reform and begin to take steps in that direction. We will monitor and evaluate the recommendations that come from the House Select Committee on Federal Legislation and consider possible support regarding their suggestions.

Address Manpower - The Shortage of Healthcare Professionals

Support significant expansion in the number of trained healthcare providers (physicians and mid-level providers), particularly primary care providers.

Strong opposition to any reduction in the number of GME slots including opposition to HR 1216 by Rep. Brett Guthrie [R-KY], which would give Congress the ability to authorize fewer GME slots than currently allotted.

Support any increase on the GME cap containing strategic controls to incentivize primary care training.