CHRISTUS Health Plan

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Christus Health Plan CHRISTUS Health is a Catholic health care system that has proudly served Nueces County and the 13 surrounding counties since July 1905. CHRISTUS Health has six hospitals, a long-term acute care hospital as well as clinics and outpatient centers in these communities. We have long served the Medicaid, under-insured and uninsured populations, which account for more than 23% of our acute care services. Our history of serving these populations and our belief that provider-owned health plans have a unique ability to manage members and improve quality outcomes compel us to continue participating as a Medicaid health plan in Nueces County. We were approved for a STAR and CHIP health plan that began accepting members in March 2012. As a faith-based, not-for-profit, provider-owned health plan, CHRISTUS Health aims to provide the right care at the right place through a fully integrated health delivery system. CHRISTUS Health is well established in the community, with long-term relationships and many access points for patient contacts. Our integrated health system allows for the establishment of a foundation of trust between the patients and the providers which helps to create of a sense of community. Our ability to work together within the system enables us to better manage patients and outcomes. CHRISTUS Health and CHRISTUS Health Plan are in it for the long term with a model that supports improving community health and wellness, while striving to deliver care in wellness and in sickness. In order to provide choice in the Medicaid health plan environment in the Nueces Service area, we must ensure a level playing field for all the managed care plans in this market. This can be achieved by implementing a fair algorithm for auto-assignment. The current auto-assignment algorithm is unfavorable to small or growing plans because it is largely based on choice election. By its very nature this disadvantages new entries into the market and allows Heritage plans to continue to grow larger while newer plans are pushed out of the market. This issue can be addressed by more tightly defining the algorithm in a meaningful way to include a mandatory re-election period for all members in a service area when a new health plan enters a market.

JANUARY 2015

www.ChristusAdvocacy.org