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Welcome to the official website for the
Texas Senate
March 29, 2011
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Senator Jane Nelson of Flower Mound
Flower Mound Senator Jane Nelson sponsored a bill approved by the Health and Human Services committee Tuesday that would reimburse healthcare providers based on treatment outcome.

(AUSTIN) — A Senate committee has given unanimous approval to a bill that would pay doctors and hospitals based on results rather than the number of procedures performed. Under the current system, doctors are paid for each procedure whether or not that procedure is effective. SB 7, by Health and Human Services Committee Chair Jane Nelson of Flower Mound, would move Medicaid and the Children's Health Insurance Program (CHIP) to an outcome based model for reimbursement. Nelson worries the current system incentivizes hospitals and doctors to perform more procedures than are necessary. "The more tests, treatments or examinations the greater the financial reward," she said.

Nelson's bill would create an advisory committee to work with the state Health and Human Services Commission to develop guidelines for state reimbursements to providers that consider efficiency and effectiveness. Payments to providers would be based on these guidelines, which would take into account factors like emergency room visits, preventable complications and readmissions. Reimbursements would be reduced when a patient is readmitted for an avoidable complication. Medicaid recipients would be subject to co-pays for non-emergency room procedures performed in the ER. The bill also commissions a study for using the outcome-based payment model for long-term healthcare facilities, such as nursing homes. SB 7 now heads to the full Senate for consideration.

Also Tuesday, the Senate education committee considered a bill that seeks to increase teacher accountability through a more rigorous evaluation process. Committee Chair Florence Shapiro of Plano says that the current teacher evaluation system doesn't work. "Our current teacher evaluation system has become superficial and often doesn't even directly address the quality of instruction," she said.

Her bill, SB 4, would create a new provisional certificate for new teachers. New teachers would have to demonstrate effectiveness in the classroom over 3 years before they could receive a standard educator's certificate. It also uses objective measures, such as student performance, to gauge teacher effectiveness, and would require more individual teacher assessments, two per year at minimum.

Representatives of teacher groups appeared to voice their concerns about the measures used to determine teacher effectiveness. The bill as written suggests that half of the assessment score be based on improvements to students' standardized test score, which bothered some teacher groups. They want a more holistic approach to evaluating teacher performance beyond just raw test data. Shapiro offered an amendment to her bill that would delay implementation of the new performance standards for two years, to give stakeholders from all sides of the issue time to develop a fair and effective system to measure teacher success.

The Senate will reconvene Wednesday, March 30 at 11 a.m.

Session video and all other Senate webcast recordings can be accessed from the Senate website's Audio/Video Archive.