$855.5M in expenses

Cook Children's Health Plan (CCHP) Cook Children's Health Plan provides health care coverage to a vulnerable population that may not otherwise be able to access or afford care - low-income families who qualify for Medicaid and the Children's Health Insurance Program (CHIP). Members enrolled in CCHP are assured timely access to necessary medical care, including preventive services such as well-child visits, immunizations and prenatal/postpartum care. Cook Children's Health Plan's role is to manage and, in conjunction with Cook Children's and other network providers, deliver care to its members. Since it was established in 1999, the organization has successfully grown to a substantial operation, currently covering more than 120,000 members, primarily comprised of children and expectant and postpartum mothers. In addition to the nearly 2,900 providers in the Cook Children's Physician Network, members have access to approximately 1,400 additional primary care physicians, 240 OB-Gyns, 2,300 specialists, 680 behavioral health providers, and numerous hospitals, surgery centers and a variety of urgent care and clinic locations. This comprehensive network ensures access to quality health care providers for all CCHP members. Although Cook Children's Medical Center does not provide maternity services, pregnant members are closely cared for and monitored to avoid complications and premature deliveries. Texas expanded Medicaid coverage to 12 months postpartum in 2024 enabling CCHP to monitor and assist these members for a longer period of time. Cook Children's Medical Center is often the hospital of choice for members' newborns who require neonatal intensive care. Medicaid Renewal After spending much of 2023 preparing its renewal application for its Medicaid and CHIP contract with the State of Texas, CCHP learned in March 2024 that the Texas Health and Human Services Commission (HHSC) intended to exclude CCHP and two additional large pediatric hospital-based health plans from the new Medicaid and CHIP Managed Care Contracts. The state's decision, the result of a flawed process, ignored Cook Children's 20+ year track record of success in administering these programs to local families. In response, Cook Children's formally protested that the scoring process lacked transparency, ignored legislatively mandated considerations and preferences, and put non-profit community plans at an unfair disadvantage. In June 2024, Cook Children's filed a lawsuit to stop HHSC from finalizing its procurement results. A webpage called Save Cook Children's Health Plan was created to keep CCHP members, network providers and the general public informed about the plight of member families who faced the prospect of starting over with new physicians, providers and therapists if CCHP were no longer available to them. A series of articles featured families worried about losing the relationships with their medical teams. In the midst of uncertainty CCHP worked to reassure its members that their coverage remains active until a final decision is made, they may continue seeing their current physicians and providers, and that their child's health is top priority. A Travis County court in October 2024 granted a temporary injunction preventing HHSC from awarding or implementing any new contracts for the Medicaid and CHIP managed care programs. HHSC has since agreed to postpone moving forward with the new awards until after the 89th Texas Legislature has had the opportunity to address the situation in Spring 2025. Collaboration and Prevention Partnership is key to CCHP's mission to help members achieve their optimal health. The Health Plan collaborates with numerous community agencies to address members' non-medical drivers of health. Food insecurity has become an increasing barrier to optimal health among CCHP's members. During FY24, CCHP screened 1,258 unique families of which 341 (27%) screened positive for food insecurity. Eligible CCHP families received Tangelo, a food benefits program, that makes it easier and more affordable to access healthy food. Tangelo distributed nearly 21,000 pounds of food to these families. Additionally, a partnership was established between CCHP, Cook Children's Center for Community Health and the Tarrant Area Food Bank to increase food access for families and support Medicaid, CHIP and Supplemental Nutrition Assistance Program (SNAP) application assistance through a mobile market. The mobile market served more than 2,800 families, distributed 298,987 pounds of food, and provided SNAP, Medicaid and other application assistance to families. National Accreditation The National Committee for Quality Assurance (NCQA) reaccredited CCHP in 2024. The NCQA's rigorous standards for health plans relate to key performance factors such as care coordination, availability of health-related resources, and member tools for self-management of chronic disease. The reaccreditation report gave CCHP high marks for member experience, follow-up care after hospitalization for mental illness, and support to members managing blood pressure with diabetes. Maternal Health Partnership Cook Children's joined more than a dozen other health care and community groups to form the Tarrant County Maternal & Infant Health Coalition dedicated to improving the area's relatively high rates of maternal mortality, especially high among Black women in the county, and infant mortality. The Coalition is working to identify maternal and infant health resources across the community and to improve awareness of these resources and facilitate timely access to them by Tarrant Area families. In conjunction with the work of the Coalition, two CCHP employees earned their doula credentials through the United Way of Tarrant County's Doula Training program, created in partnership with Cook Children's. The program aims to help pregnant women access information, resources and care for a healthy pregnancy and safe labor and delivery. CCHP's certified doulas work one-on-one to provide education and help create members' plans for birthing and recovery. One of the most important aspects of doula care is following up after the birth. CCHP members reported how much the doulas' support helped them through their pregnancy journey. Transformative Partnership Construction continued during FY24 on the Las Vegas Trail Neighborhood Health Center, a first-of-its-kind partnership to bring critical health services to an underserved area of Fort Worth. The center, scheduled to open in 2025, will be home to various pediatric and adult medical and social services. Cook Children's is teaming up with JPS Health Network, the City of Fort Worth and local non-profit organizations in this innovative plan to transform Fort Worth's struggling LVT neighborhood into a safe and thriving community. Approximately 7,500 CCHP members live in the LVT area, making CCHP a key player in service delivery and care coordination at the new center. CCHP staff will be embedded at the location to help members navigate the health care system and access resources. For example, for those without internet service who need to attend a telehealth appointment, there will be private space equipped with internet and video where community residents can access this service with the help of an on-site CCHP representative. CCHP community health workers will also assist in the Health Education Center, where LVT plans to offer instruction in nutrition, pregnancy, English as a second language, high school diploma equivalency and more. A unique Workforce Initiative has been finalized with Tarrant County Community College and will be offered to the first cohort in fall 2025. The training will equip residents with skills in customer service, phone management, data entry and other entry-level health care administrative tasks. CCHP's support for this initiative will give LVT residents employable skills to access well-paying jobs within the health industry while also building a new pool of qualified candidates for filling staffing needs at Cook Children's and JPS. All of these collaborations and value-added resources provided by CCHP help improve the health and well-being of members.