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A grim diagnosis for Texas children

With a fifth of Texas children going without health insurance, the state’s child health system ranks among the nation’s worst.

That’s the finding of a new “scorecard” from The Commonwealth Fund, which ranked Texas at No. 46 among the 50 states and Washington, D.C.

The study, to be released Wednesday, examined each state’s performance on 13 separate measures that focused largely on healthcare quality and access to care.

Although states in the Northeast and Upper Midwest generally fared best, none was consistently tops. And there were broad regional disparities, with room for improvement even among the best performers.

“There are wide variations across the states,” Karen Davis, Commonwealth Fund president, said Tuesday. “One major effort states can take to improve quality of care is to provide health-insurance coverage for children, particularly low-income children.”

Insurance matters

That’s because uninsured children too often lack a “medical home” where a family doctor can give them routine and preventive care, said Dr. Gary Floyd, an administrator at Cook Children’s Health Care System.

“Any problems found in a well-child visit are not picked up and taken care of early,” he said. “And then, when the child gets sick, these folks find themselves with really no physician, no office to pick up a phone and say: ‘Hey, my child has a fever. I need him seen today.’”

Nonetheless, the state did perform well on measures of health outcomes — specifically, infant mortality and the risk of developmental delays among young children.

The Commonwealth Fund report didn’t speculate about why those Texas outcomes were better than in many other states. But Floyd, who is medical director of pediatric urgent-care centers and public policy, said the results could be tied to state efforts to provide prenatal care to pregnant mothers and to prevent premature births.

Improvements seen

With lawmakers’ move to expand the government-funded Children’s Health Insurance Plan, about 127,000 children have been added to the rolls since September, she said.

“We have made some progress,” Best said. “That is very, very positive. And that’s a sign of what can be done to reduce the number of uninsured children.”

Floyd also noted that the state last year boosted payments to physicians who treat low-income Medicaid recipients. The bump in pay has averted an ongoing exodus of doctors from the program, making more physicians available to poor children, he said.

The Commonwealth Fund’s latest findings are in line with a previous study by the organization, which last year found that Texas’ overall healthcare system — for adults and children — ranked among the nation’s worst. The state landed at No. 49 on that scorecard, in large part because so many Texans have no health insurance.