Clients, others weigh in on Sendero Health Plans’ uncertain future

Austin American-Statesman (TX)

April 16--After Sendero Health Plans reported last week that the low-income health care provider is on track with its financial goals and plans to break even, officials walked clients and other interested parties through the numbers and Central Health board's timeline to decide its fate during a public hearing Monday.

Concerns centered around Sendero's uncertain future and what could potentially happen to the insurance nonprofit and its patients if it were to shut down.

Sendero, which has provided about 75,000 Central Texas residents with health insurance since 2014, almost ceased operations last year after Central Health board members voted to shut it down because it was losing money. Citizens urged Travis County's health district's board members to change their minds, and they did -- with the caveat that the nonprofit needed to reverse its negative financial outlook.

Central Health and Sendero officials on Monday reported that they on are track with their goals and plan to break even. The board will decide in June whether to continue the program.

Morgan Whithoff, a member of the health plan, said he wanted to understand "how terrified we should be and if we have to be worried about any actions we need to take."

Officials said it was hard to say this early in the year, while Sendero's finances are still uncertain.

"I need to be blunt about where we are right now with Sendero," Central Health CEO Mike Geeslin said. "It's still early in the year, and we're not out of the woods by any stretch of the imagination. ... Right now, we're showing a projection to break even or slightly better. But as we mentioned before, with the Affordable Care Act marketplace there's a lot of volatility. ... As we get closer to June, we'll have more claims data, we'll have actuarial opinions and we'll be able to do a better job of coming back to you and saying, 'OK, here's how we think things are going to play out.'"

Some people raised concerns about how shifts in coverage can disrupt patients' treatment.

"The services a patient can currently access with Sendero are really different than the services they can access with (Central Health's Medical Access Program), such as dialysis, that they might not be able to access if they come back to (the Medical Access Program)," said a woman who declined to give her full name but said she's a manager at CommUnityCare, another Central Health organization.

Sendero brought in 223 members from the Medical Access Program as part of a plan to siphon more Affordable Care Act funding.

Frank Rodriguez, a former Central Health board member, asked about the higher rates that Sendero patients were now paying, and officials said they shared his concerns.

"The rate-setting is a painful process," said Wesley Durkalski, Sendero's president and CEO. "We fully recognize the affordability issue and are always challenged to keep that as low as we can. ... Going forward, we would like to be in a position where, ideally, this program will execute successfully, so we can expand it. That would stabilize our financials, and then we could offer lower premiums to cover more of the population. That's the ideal scenario."

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