From Karen Love, President, Cook Children's Health Plan (CCHP): STAR Medicaid and Children’s Health Insurance Program (CHIP) Managed Care Contract
The Cook Children's Health Plan (CCHP) received some very surprising news earlier this month: The Texas Health and Human Services Commission (HHSC) issued a notice of intent that it does not plan to award the Cook Children's Health Plan with a new contract for the STAR Medicaid and Children’s Health Insurance Program (CHIP), which provides health care coverage for thousands of families in our service area.
Our current STAR/CHIP contract remains in effect until Aug. 31, 2025, and we are hopeful for a resolution well before the contract expiration date. (NOTE: We will be staying in touch with our Members, Providers and all of you as we work through this issue.)
THE IMPACT
- This decision impacts more than 125,000 Cook Children's Health Plan Members, many of whom rely on Cook Children's Providers for vital health care services. At this time, nothing will change for our Members and families who are a part of this plan.
- Approximately 25%* of our patients are Cook Children’s Health Plan members, and losing this contract will very likely be detrimental to our health plan operations, which employs more than 400 individuals.
* Note: This 25% statistic includes Cook Children's Health Plan Members who have a Cook Children’s primary care physician. In any given year, roughly 50% of our Members will have an encounter with a Cook Children’s provider across the system. That figure is even higher among our STAR Kids population.
NEXT STEPS
We are committed to fulfilling our Promise to care for every child in need, regardless of their financial situation. This decision contradicts that guiding principle, and we are taking decisive action.
We are launching an immediate protest and are exploring all avenues to overturn this decision. Additionally, we are working with stakeholders across the state to address this decision, which clearly does not represent the best value for the Texas Medicaid program.
Cook Children's has a long history of serving our community and providing high-quality care. We believe the state's decision overlooks the significant value we bring to the market. As a non-profit, community-based health plan, we understand the unique needs of our Members and address barriers to health well beyond just medical care.
We are confident in our position and will fight this decision both legally and politically. We have the full support of our Board of Trustees and System Leadership team, and we will engage our community and partners in advocacy efforts as appropriate.
We will keep you updated on further developments through Connect Newsroom, and will continue to update these frequently asked questions (FAQs). If you have other questions that are not listed on the FAQs, please send them to us here: internalcommunications@cookchildrens.org.
Recognized as the Best Place to Work in Health Care by Forbes for 2024, Cook Children's prioritizes the well-being of all of our employees, and we are committed to taking care of all of you throughout this journey.
We value your continued support as we work to ensure continued access to quality health care for all children who rely and depend on Cook Children's.
A transcript of Karen's video message above is below:
Despite scoring essentially a 92 on the test, we were not awarded a new STAR/CHIP contract.
We’re not alone – neither Texas Childrens nor Driscoll Health Plans were awarded new contracts either.
This is in no way a reflection of the value that we bring to the Texas Medicaid program.
In fact, that’s the point we will be making in our fight – the winner takes all scoring methodology for this request for proposals (RFPs) totally ignores plans with long standing tenure in the program, who are embedded in the communities they serve, who have excellent Member and Provider satisfaction scores, and impressive quality outcomes.
It’s merely a paper exercise – kind of like a term paper at the end of the semester – and these national companies with entire departments devoted to creative writing wrote better term papers.
It doesn’t mean that they can deliver on their promises the way we have delivered on ours for more than 20 years.
Quoting Dr. Kimberly Aaron, vice president of Clinical Affairs, this RFP process so missed the mark to deliver a choice that the families in our community should have.
We will fight this decision both legally and politically every step of the way and I have confidence that we will be successful.
We have the full faith and credit of the Cook Children’s Health Care System behind us in this fight and will engage our community and our partners in helping to advocate for us in this fight.
The current contract ends Aug. 31, 2025, and there will be at least a year of runout activity after that. The STAR Kids contract will run through Aug. 31, 2026 with a similar runout period after that.
Thank you. Keep your heads up. Keep doing the wonderful work that you do for our Members, Providers and each other every day, and we will keep you informed of our progress.