Health Services

1. Health insurance rates keep rising, with the annual cost for family coverage in Texas the 9th
highest in the country. These costs are primarily driven by the prices charged by healthcare
providers, such as hospitals and doctors.
These medical services are a critical component of the overall well-being of Texans. But much
of what influences health is determined by day-to-day non-medical factors.
Medicaid
The Medicaid program in Texas provides health and medical services to low-income children,
pregnant women, and adults with disabilities. It is jointly funded by state and federal
governments. The program helps ensure that the most vulnerable Texans have access to
quality care and live in their own communities. Today’s Texas Medicaid is a comprehensive
medical and health coverage program that keeps Texans healthy, improves lives, and saves
taxpayer dollars.
Texas Medicaid uses a formula that considers household income to determine eligibility. Those
with incomes below 200% of the federal poverty level qualify for the program. Adults who
receive disability benefits may also be able to buy into Medicaid through the program. The
program offers comprehensive prescription drug coverage. However, there are some limitations
and restrictions on the types of drugs that can be purchased.
In addition to offering coverage for essential health needs, Texas Medicaid has a strong focus
on prevention. It offers periodic screenings and diagnostic tests to help prevent disease, illness,
and injury. It also focuses on developing medical homes, which are models of care that are
accessible, continuous, comprehensive, family-centered, and coordinated. The goal of a
medical home is to make sure that every patient has an appropriate primary care clinician and
can be connected with other services, including community-based support and treatment
programs.
Preventive care
Preventive care helps detect or prevent serious diseases or medical problems, such as cancer.
It includes annual check-ups and immunizations, as well as certain tests and screenings. It can
also help people manage chronic conditions. Some examples of preventive care include annual
mammograms, blood pressure checks, and cholesterol screenings. Other examples include Pap
smears and screening for prostate cancer. Preventive care is different from diagnostic care,
which involves services or tests that your doctor orders to find something specific, such as a
follow-up mammogram after an abnormal result on a previous mammogram.
The Affordable Care Act requires most health plans to cover preventive care without cost
sharing, including medications that prevent HIV transmission and other lifesaving screenings.
But a judge’s ruling invalidated the requirement, and it could leave millions of patients at risk.
Medicare Rights supports a stay of the decision while it makes its way through the courts.

2. The federal government set up three expert bodies to identify high-value preventive services:
the Advisory Committee on Immunization Practices for vaccines, the U.S. Preventive Services
Task Force for general adult preventive services and screenings, and the Health Resources and
Services Administration (HRSA) for children’s and women’s preventive services. All of these
groups have recommended a list of preventive services that health plans must cover. The ACA
preventive services coverage requirement has significantly increased the use of these important
preventive services, improving health outcomes and reducing racial disparities in access to
care.
Supportive palliative care
With tremendous advances in cancer care, patients are now living with a diagnosis for longer
periods of time. However, many patients still suffer from the side effects of their disease and
treatment. Many of these side effects, such as pain, nausea, fatigue and depression, can be
managed with supportive care. This specialized service can help alleviate these symptoms and
improve the quality of life for patients with serious illness.
Supportive palliative care is a recognized medical specialty that focuses on comfort, care and
planning for patients and their families. It addresses all the ways a patient’s serious illness
affects them, including physical, social and spiritual needs. It also includes identifying the goals
of care and assisting in a patient’s advance directives.
The care is delivered by a team of professionals, which may include an advanced practice
registered nurse (APRN), physician assistant, nurses, social workers, music therapists and
chaplains. They work in partnership with the patient’s primary health care provider. This care
can be given in a hospital, clinic, home, or assisted-living facility and can be provided alongside
curative treatments.
The UT Southwestern Medical Center palliative care team provides services for inpatients at the
William P. Clements Jr. University Hospital and Zale Lipshy Pavilion, as well as in outpatient
clinics at Parkland Memorial Hospital and Harold C. Simmons Comprehensive Cancer Center.
The team works with the patient and their family to identify goals of care, address symptom
management and assist in advance directives.
Prevention
There are many different types of preventive healthcare. Primary prevention focuses on keeping
diseases from developing, while secondary prevention aims to stop conditions that have already
developed from progressing or causing complications. Tertiary prevention focuses on
rehabilitation strategies and changing our social environments so that people who have been
affected by diseases can continue to lead meaningful lives. While medical treatments are
important, preventing disease and promoting good health is just as crucial.
CPRIT has invested in effective community-based prevention projects to help Texans stay
healthy. These include innovative healing centers that promote resiliency and social connection

3. in communities impacted by ACEs or exacerbated by COVID-19. Another project helps Texans
find treatment for substance misuse and related behavioral health needs.
However, the state’s high rates of uninsurance have significant implications for health care.
Those without insurance are less likely to receive care and are more likely to die from disease
or injury. They are also more likely to visit the emergency room, where costs are typically
higher.
The Texas Department of State Health Services works with community partners and medical
associations to support Texans who need help accessing healthcare. These programs include
local resource coordination groups, which help Texans find personal care, nursing home
assistance and long-term care facilities. They also work with federally qualified health clinics,
medical associations and other community partners.