By Delisi                                            H.C.R. No. 234
         76R12625 JLZ-F                           
                             HOUSE CONCURRENT RESOLUTION
 1-1           WHEREAS, Managed care plans, including for-profit, nonprofit,
 1-2     individual practice, and group practice health maintenance
 1-3     organization (HMO) models, continue to play an important role in
 1-4     health care insurance in Texas; and
 1-5           WHEREAS, The State of Texas has a vested interest in various
 1-6     outcomes and measures surrounding these entities as it continues to
 1-7     enroll its Medicaid population in such plans, and our children's
 1-8     health insurance initiatives support managed care models; and
 1-9           WHEREAS, The Texas Legislature continues to face
1-10     consideration of  mandating benefits and regulating managed care
1-11     plans without regard for various models for managed care plans,
1-12     while there may be differences in consumer satisfaction or health
1-13     outcomes between different HMO models; and
1-14           WHEREAS, Given the State of Texas' continued support of
1-15     managed care plans, Texas employers' continued reliance on such
1-16     plans, and the Texas Legislature's continued obligation to pass
1-17     laws regulating the industry, it is important to determine whether
1-18     significant differences exist in the quality and health care
1-19     outcomes between the various types of managed care plans; now,
1-20     therefore, be it
1-21           RESOLVED, That the 76th Legislature of the State of Texas
1-22     hereby direct the Texas Department of Insurance and the Office of
1-23     Public Insurance Counsel, within their existing resources, to
1-24     perform a study comparing for-profit HMOs and nonprofit HMOs, as
 2-1     well as individual practice association (IPA) and group medical
 2-2     practice HMOs, with regard to quality indicators, customer
 2-3     satisfaction, and financial measures; and, be it further
 2-4           RESOLVED, That the study shall have two focuses:  (1) a
 2-5     comparison of nonprofit and for-profit HMOs, and (2) a comparison
 2-6     of IPA and group medical practice HMOs, each comparison using
 2-7     Health Plan Employer Data and Information Set (HEDIS) Scores,
 2-8     consumer satisfaction surveys, consumer complaint ratios, premium
 2-9     rates, expense ratios, administrative costs, and financial solvency
2-10     issues, in addition to other outcomes and measures deemed relevant
2-11     by the Texas Department of Insurance; and, be it further
2-12           RESOLVED, That the study shall include participation of the
2-13     commissioner of insurance, three representatives from the business
2-14     community, three representatives of hospitals, three
2-15     representatives who are physicians involved in direct patient care,
2-16     and three representatives who are consumers not professionally
2-17     involved in the purchase, provision, administration, or review of
2-18     health care or health care insurance; and, be it further
2-19           RESOLVED, That the Texas Department of Insurance shall
2-20     present the results of the study to the Texas Legislature not later
2-21     than December 1, 2000; and, be it further
2-22           RESOLVED, That the secretary of state forward an official
2-23     copy of this resolution to the commissioner of insurance.