HBA-EDN S.B. 283 77(R) BILL ANALYSIS Office of House Bill AnalysisS.B. 283 By: Nelson Public Health 5/7/2001 Engrossed BACKGROUND AND PURPOSE Healthcare for patients suffering from chronic disease consumes a majority of all health expenditures. In the managed care population, studies have indicated that enrollees with chronic illnesses may consume more than sixty percent of a group's healthcare costs. Risk factors such as obesity and lack of exercise are increasing among Texas' children, setting the stage for an epidemic of chronic conditions such as diabetes and heart disease. More children are experiencing chronic health problems than ever before; for example, since 1980 the prevalence of asthma in the United States has increased by 160 percent in children. Recent reports suggest that many patients with a chronic disease are not receiving the appropriate level of care to effectively manage their conditions. Contributing factors include medication noncompliance, inadequate patient education and secondary preventive services, unexplained clinical variation in treatment, and inconsistency among physicians in following established treatment recommendations. Senate Bill 283 requires the Health and Human Services Commission to study the benefits, costs, and effectiveness of applying disease management principles in the delivery of Medicaid managed care services. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that this bill does not expressly delegate any additional rulemaking authority to a state officer, department, agency, or institution. ANALYSIS Senate Bill 283 amends the Government Code to require, rather than authorize, the Health and Human Services Commission (HHSC) to study the benefits and costs of applying disease management principles in the delivery of Medicaid managed care services to recipients with chronic health conditions. The bill requires HHSC, in conducting the study, to evaluate the effectiveness of those principles in reducing longterm health care costs under the Medicaid managed care program and in improving patient care and utilization patterns of recipients. The bill authorizes HHSC to conduct the study in conjunction with an academic center. The bill also requires HHSC to ensure that managed care organizations under contract with HHSC to provide health care services to recipients implement special disease management programs to address chronic health conditions. EFFECTIVE DATE September 1, 2001.