Section 543A.0201 - [Effective 4/1/2025] Payment Initiatives; Determination Of Benefit To State(a) The commission shall establish payment initiatives to test the effectiveness of quality-based payment systems, alternative payment methodologies, and high-quality, cost-effective health care delivery models that provide incentives to physicians and other health care providers to develop health care interventions for enrollees or recipients that will: (1) improve the quality of health care provided to the enrollees or recipients;(2) reduce potentially preventable events;(3) promote prevention and wellness;(4) increase the use of evidence-based best practices;(5) increase appropriate physician and other health care provider collaboration;(7) improve integration of acute care services and long-term services and supports, including discharge planning from acute care services to community-based long-term services and supports.(b) The commission shall:(1) establish a process through which a physician, other health care provider, or managed care organization may submit a proposal for a payment initiative; and(2) determine whether implementing one or more proposed payment initiatives is feasible and cost-effective.(c) If the commission determines that implementing one or more payment initiatives is feasible and cost-effective for this state, the commission shall establish one or more payment initiatives as provided by this subchapter. (Gov. Code, Secs. 536.202, 536.203(a).)Tex. Gov't. Code § 543A.0201
Added by Acts 2023, Texas Acts of the 88th Leg.- Regular Session, ch. 769,Sec. 1.01, eff. 4/1/2025.