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Dr. Martin Garza

The decision by Texas Health and Human Services to exclude Driscoll Health Plan from the Medicaid program is a serious misstep that threatens the health care of children and pregnant women in South Texas. As a physician in Edinburg, I have seen the transformative impact Driscoll Health Plan has had on our community. The potential loss of this invaluable provider is a matter of urgent concern.

Driscoll Health Plan has been a beacon of hope for many families in South Texas, offering comprehensive healthcare services to more than 190,000 children and pregnant mothers. In a region where healthcare resources are already stretched thin, the exclusion of Driscoll from the Medicaid program could lead to significant gaps in care. Driscoll’s investment in maternal fetal medicine and other pediatric services has been instrumental in improving health outcomes and reducing healthcare costs. The plan’s efforts have saved the state more than $1 billion in NICU costs over the past decade, a testament to the effectiveness of its coordinated care model.

The procurement process that led to Driscoll’s exclusion seems deeply flawed, failing to consider the qualitative benefits of established nonprofit health plans. Driscoll Health Plan’s high provider satisfaction rates and positive patient outcomes highlight its critical role in the community. By prioritizing for-profit insurers, the state risks compromising the quality and accessibility of health care for low-income families. For-profit companies may not have the same commitment to patient care as nonprofit providers, potentially leading to reduced service quality.

Continuity of care is crucial for effective healthcare delivery, especially for children and pregnant women. Driscoll Health Plan’s deep understanding of the local cultural and socio-economic context enables it to provide personalized and effective care. The potential disruption caused by switching to new providers could have severe consequences for patient health and well-being. Many families rely on the trust and relationships they have built with Driscoll Health Plan, and any interruption in services could undermine years of progress.

The broader implications of this decision are equally concerning. By excluding nonprofit health plans, Texas risks destabilizing its Medicaid system and undermining efforts to improve health outcomes for low-income families. Nonprofit plans like Driscoll have demonstrated their ability to deliver high-quality care while reducing costs, making them invaluable partners in the state’s healthcare system. The focus should be on enhancing and expanding these proven models of care, not dismantling them in favor of untested alternatives.

As healthcare providers, we must advocate for decisions that prioritize the well-being of our patients. The exclusion of Driscoll Health Plan is a short-sighted decision that threatens to undo years of progress in pediatric health care in South Texas. We urge Texas HHS to reconsider this decision, taking into account the significant contributions of nonprofit health plans and the needs of the communities they serve. Ensuring access to high-quality health care for every child and pregnant mother should be our top priority, and that requires building on the successes of trusted providers like Driscoll Health Plan.

In conclusion, the decision to exclude Driscoll Health Plan from Medicaid contracts is a potential healthcare crisis that must be addressed. The proven track record of nonprofit plans like Driscoll should be recognized and valued. We call on Texas HHS to prioritize the health and well-being of our communities by reconsidering this decision and ensuring that Driscoll Health Plan remains a vital part of our healthcare system. Our children and pregnant mothers deserve nothing less.

Dr. Martin Garza, M.D., is a pediatrics specialist in Edinburg.