Priorities | Memberships | Existing Advocacy Challenges

Government Affairs & Advocacy

Texas Health plays an active role in the public policy arena and advocates for enhanced health care delivery that strengthens our ability to improve the health of the people in the communities we serve.

Specifically, we strongly support provisions of health care reform that increase the number of the insured, reward hospitals based on the value and quality of the care we provide, and focus on primary care, prevention and well-being. This helps us not only sustain our health care system, but individuals’ health.

Texas Health does not directly nor indirectly support or oppose any candidate for elective office, nor do we contribute to political campaigns or activities. Our Legislative Activities Policy mandates that all officers and employees adhere to all federal and state statutes, rules and regulations concerning legislative and lobbying activities. Our employees cannot conduct personal political activities at work or on Texas Health Resources property, nor can they be reimbursed for any political-related expenses.

Before we engage our federal, state and local policymakers, we first:

  • Identify issues and evaluate their impact on the organization.
  • Inform employees, physicians, trustees, volunteers, community partners and industry associations about important issues so they can help promote our public policy agenda.
  • Organize grassroots advocacy with health system leadership and community organizations.
  • Educate employees about the importance of voting.


Texas Health Resources collaborates with trade associations, industry groups and other key stakeholders to maximize our effectiveness in the legislative and regulatory arenas. Our primary partners include:

  • American Hospital Association
  • Premier Inc.
  • Healthcare Leadership Council
  • Texas Hospital Association
  • Texas Association of Voluntary Hospitals
  • Texas Health Institute
  • Dallas Fort Worth Hospital Council
  • Health Industry Council
  • North Texas Commission
  • Dallas Fort Worth Business Group on Health
  • Chambers of Commerce

Existing Advocacy Challenges

Within an ever-changing and complex political and legislative landscape, Texas Health continued our efforts in 2012 to:

  • Enhance communications and outreach with internal and external stakeholders.
  • Strengthen industry and community networks, coalitions and collaborations to address legislative and regulatory changes.
  • Implement advocacy strategies that advanced the organization’s mission, vision and values.

Health Care Reform

Texas continues to be the state with the highest number of uninsured individuals in the nation, which puts a tremendous financial strain on hospitals that are federally mandated to provide emergency care regardless of a patient’s ability to pay.

In 2012, state leaders announced that they do not intend to expand the Medicaid program under the Affordable Care Act (ACA) as it will further increase both the state’s and nation’s debt. Without Medicaid expansion, however, many Texans will remain uninsured and be forced to seek health services in the emergency room. This will increase costs for the privately insured and increase uncompensated care for health care providers that treat Medicaid patients.

Texas Health continues to urge lawmakers to reform the health care system to ensure citizens have access to affordable health insurance. We will continue to shape the implementation of health care reform by advocating for the transformation of health care delivery across the continuum of care. Moreover, we will continue to promote meaningful improvements in quality and cost containment models that do not compromise our ability to care for the vulnerable and underserved.

Quality and Care Coordination

Texas Health supports financial incentives that reward providers for implementing best practices that eliminate hospital-acquired infections and preventable readmissions. Additionally, we support the development of Accountable Care Organizations (ACOs), which better align provider compensation with efforts to improve care coordination,quality and cost reductions.

However, health systems such as ours need further regulatory relief at both the federal and state levels to achieve the goals of accountable care. For example, some of the legal hurdles we currently face include:

  • Antitrust – The ACA offers financial incentives to health providers to consolidate in an effort to reduce operational costs. However, reduced competition for health services can impede innovation, limit consumer choice and escalate costs.
  • Stark Law – Under the law, physicians cannot refer Medicare and Medicaid patients to entities in which they have a financial relationship. This can interfere with Texas Health’s ability to ensure patients receive the care they need when and where they need it most.

Access to Care and Workforces Issues

Texas’ rapid population growth and propensity for chronic diseases like obesity, diabetes, heart disease and cancer increase the need for health care services. Unfortunately, these challenges are compounded as our state currently faces a critical shortage of physicians, nurses and allied health professionals.

Texas Health Resources advocates for increased higher education funding for graduate medical education (GME) for physicians. More residency slots and funding for GME are needed to keep Texas-trained physicians in the state, where they will be more likely to set up practice. Short-sighted budget cuts have contributed to the inability to produce enough physicians to meet our growing population. In 2011, Texas Health supported the passage of a state law that enabled rural hospitals to attract, recruit and employ physicians.

Additionally, the state established a Professional Nursing Shortage Reduction Fund to increase nursing school enrollment and improve graduation rates in an effort to produce more nurses. Texas also faces a shortage of nursing faculty. In 2011, state policymakers reduced contributions to this fund from $50 million to $30 million. Texas Health supports efforts to restore program funding, as it helps us meet the projected demand for health care services as older nurses retire.

Fiscal Sustainability

More than ever, health care systems need stability in the Medicare and Medicaid programs. Texas hospitals are not adequately reimbursed for the costs of providing Medicaid inpatient care. Medicare pays slightly better, but Texas hospitals still lose a great deal on treating Medicare patients. Unfortunately, this downward trend is unsustainble for hospitals and shifts costs to the private market.

Legislatively mandated Medicare and Medicaid cost-containment initiatives create funding instability and reimbursement uncertainty for hospitals. These policy objectives would be better achieved through a pay-for-performance approach instead of arbitrary payment reductions. Texas Health will continue to advocate for adequate and fair reimbursement to help us provide compassionate, quality and affordable care.

No matter what happens in Washington, D.C. or in Austin, Texas, Texas Health is moving forward with the transformation strategy we began implementing years ago before the passage of health care reform. We built flexibility into our strategy to meet changing regulatory and legislative requirements, while keeping our focus on efforts that improve quality and patient safety across the continuum of care.

Texas Health will continue to inspire change in the way people think about their own health and well-being, and we will advocate for non-partisan, collaborative approaches that improve the health of the people in the communities we serve.

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