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Righting the ship An interview with HHSC’s newest captain BY AMY LYNN SORREL Last

September, Kyle Janek, MD, took the helm at the Texas Health and Human Servic- es Commission (HHSC) as its new executive commis- sioner. The anesthesiolo- gist already has a lot on his plate.

He will start the new year by asking lawmakers for a $4.7 billion emergen- cy appropriation to cover a Medicaid shortfall from last legislative session and to keep the program that comprises the largest share of his budget from run- ning out of money as early as March. And the former state representative and senator acknowledged the hard work facing the agen- cy. That includes improv- ing physician participation in not just Medicaid, but also the Women’s Health Program (WHP). That pro- gram has been plagued by court wrangling over the legislature’s exclusion of “abortion affiliates,” a po-

could you take a moment to address physicians, who are interested to hear from you as a peer about how you plan to work with and work for doctors in car- rying out your agency’s goals?

New Texas Health and Human Services Director Kyle Janek, MD, acknowledges that the agency faces difficult challenges, but he’s optimistic it can overcome them.

tential withdrawal of federal funding, and a proposed “gag or- der” that, until its reversal in October, would have prohibited WHP doctors from discussing abortion with patients. Nevertheless, Dr. Janek expressed optimism for innovative

approaches that he hopes will help “turn the ship around.” Below are excerpts from Texas Medicine’s November inter- view with Dr. Janek. Watch the full interview online at www

Texas Medicine: Your agency serves a broad audience. But

Dr. Janek: This agency covers a lot of territory. Everyone thinks it’s just about Medicaid and CHIP [Children’s Health Insur- ance Program]. But that’s the funding mechanism. It is considerable, and it’s a big piece of what Texas physicians do. Our job is to do the most we can with the dollars the legislature gives us. I worry that fewer doctors are now accepting new Medicaid patients. I applaud that they continue to take care of the Medic- aid patients they’ve got. But they are leery of taking on new ones with threats of lower pay, more regula- tion, that sort of thing. I would love to see us create

a system of excellence, and quality, and better reimbursement to providers of all stripes that encourages those providers to knock on the door and say, “Hey, I want in.”

Texas Medicine: Only one-third of doctors take new Medic- aid patients, for a number of reasons. What do you plan to do to help get that number up?

Dr. Janek: Turning it around is not going to be easy. The number has been drifting down, and it’s been a long time com-

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