Talking Points for Cook Children's Health Plan Providers

OVERVIEW OF SITUATION: In March 2024, the Texas Health and Human Services Commission (HHSC) announced changes to the STAR/CHIP managed care program beginning in September 2025. At that time, families currently enrolled in CCHP will have the option to choose a new plan from four other providers: Aetna, Blue Cross Blue Shield of Texas, Molina and UnitedHealthcare.

We expect you share our shock and disappointment in this radical departure from the current landscape.

IMPACT: Nearly 125,000 CCHP STAR and CHIP Members could lose access to vital health care services and providers.

An additional 8,000 medically complex children in the STAR Kids program could also be impacted as the loss of our STAR/CHIP contract threatens the sustainability of our overall Health Plan. More than 170 of these children are ventilator-dependent.

OUR TOP PRIORITY: Your Patients' Care: Please reassure families there's no immediate change until after the current contract expires on Aug. 31, 2025. They can continue seeing you and other CCHP network physicians and providers just like they do today.

KEY MESSAGES TO USE WITH CCHP MEMBERS, PATIENTS AND FAMILIES:

We know the recent news about CCHP's contract might worry you. But don't be concerned!
Your health coverage with Cook Children's Health Plan is still in place and good for more than a year.
You can still see all your doctors and specialists, just like always.

WE ARE FIGHTING THIS DECISION: CCHP has filed a protest of this decision and will pursue all other actions available to us.

WHY COOK CHILDREN'S MUST REMAIN A PART OF THIS PROGRAM:

Local, Non-Profit: We have a deep understanding of our community's needs because we live and work here and provide more than $200 million in community benefit and charity care per year.
Proven Track Record: We have more than 20 years of high Member and Provider satisfaction, quality health outcomes and cost-savings for the State.
Focus on Social Determinants: We address each Member's holistic needs by tackling barriers to health, including food insecurity and transportation, and offering enhanced support for healthy pregnancies, and effective preventive care.
Continuity of Care: More than 56% of the Medicaid and CHIP Members enrolled today statewide would need to change plans if this decision stands when the State's own best value criteria for managed care contracts requires consideration of continuity of care for patients.

IMPACT ON PATIENTS AND THE COMMUNITY: If you would like to support us, we invite you to highlight some of the following points when talking with agency and legislative officials who can influence this decision:

Patients could lose access to their established doctors and providers, making it harder to find new in-network providers. This risks them falling behind on important checkups and treatments until a health crisis arises.
Vital health care services across Texas could be disrupted. In the Tarrant Service Area alone, a staggering 76% of Members will be forced to find new plans.
Families would face increased stress and uncertainty. This comes on top of the disruptions caused by the pandemic and the State's failed efforts to ensure appropriate eligibility redeterminations, adding to the anxiety families are already experiencing.
Thousands of medically complex patients could be significantly impacted. This decision could create challenges in accessing specialized care they rely on.
Denial of the contract weakens Cook Children's ability to serve all children in need. Our promise states: "Knowing every child's life is sacred, we promise to improve the well-being of every child in our care and our communities." This decision, if it stands, jeopardizes our commitment to the community.
The overall health and well-being of the community could suffer. Losing CCHP's services could have a ripple effect on the health of the entire population.

KEY POINTS TO REMEMBER:

Focus on how this decision affects patient care and the community.
Use clear, concise and reassuring language.
Offer families the Cook Children's website (www.cookchildrens.org) for more information.
Contact us at cchpproviderrelations@cookchildrens.org if you have further questions.

By working together, we can ensure continued access to quality health care for the children and families who depend on you and Cook Children's Health Plan. North Texas residents deserve a meaningful choice of managed care plans to choose from, including CCHP as the area's only local, community-based, non- profit plan.