Travis County moves Sendero forward with fingers crossed

After much back-and-forth over the fate of Sendero Health Plans, Central Health has presented a strategy to leverage its funds in hopes of saving the insurance company from being terminated. The Travis County Commissioners Court admitted the precarious nature of the entire situation but unanimously approved the Central Health Fiscal Year 2018-19 budget and tax rates on Tuesday morning.

The core issue with Sendero is the lack of financial stability, which led to the Sept. 12 decision to disband the company. Until last Saturday, this flaw appeared to be fatal, despite public protest for the Central Health Board of Managers to find a better solution. Last Saturday, however, the board responded to complaints by reversing its previous decision and adopting a strategy that it hopes can save Sendero from financial collapse.

This strategy consists in leveraging funds to maximize federal reimbursements to benefit everyone involved by moving hundreds of Medical Access Program (MAP) members over to Sendero. Those moved over will be members who have more medical issues than the general population, which will qualify Sendero for more funds.

“The way the Affordable Care Act is designed, if you have a membership that is … sicker or has more chronic conditions than the average, you pull down additional federal dollars,” explained Central Health CEO and President Mike Geeslin. “So that’s the business plan.”

As Commissioner Brigid Shea noted, this approach could also potentially benefit Travis County, which currently covers the medical costs of MAP patients. “Seems to me by transferring … some of the really sick population into Sendero, which gets three to six times the reimbursement from the federal government that you can get through the MAP program, we would benefit,” said Shea. “There would be more money available to provide medical care to more people.”

The strategy seems promising under the current circumstances, but national politics are yet another cause of deep anxiety for Central Health and the Commissioners Court alike. Talk in Washington of dismantling the Affordable Care Act threatens potential collapse of Central Health’s plans.

Geeslin, however, remains optimistic.

“In the insurance business at this point in time in the life cycle of Sendero, but also in the Affordable Care Act marketplace with all its political turmoil, if you will, you either have to be all in or you have to get out,” he said. “And so this is an effort that is calculated. Yes it has risks, but they are calculated risks.”

Faced with these unknowns, County Judge Sarah Eckhardt let the burden of foresight remain with Central Health management.

“You all know the risk and the benefit of the decision to come before your board better than I will ever know,” she said, addressing Geeslin and several Central Health board members also present. “I do not sit in those executive sessions with you all, with the proprietary information necessary to make these decisions, and I trust you.”

There are still many questions surrounding Sendero that only time can answer. Central Health has prepared to review the plan with a third-party actuary in June of next year and determine objectively if it is working or not. They will also be scheduling a December meeting this year with the Commissioners Court to discuss the enrollment process and give an update on the plan.

In lieu of further deliberation and involving the Central Health Board of Managers in the discussion, Commissioner Gerald Daugherty made a motion to pass the items in approval of the Central Health budget and tax rates. The motion passed unanimously.

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