Health Policy Reports


  • Connecting Local Governmental Finances to Local Health Outcomes in Texas

Screen Shot 2018-03-20 at 3.09.24 PM.png
Previous research has demonstrated a link between higher public expenditures for public health and social services and better health outcomes at the county level. Understanding the financial resources available and investments made at the county level are important for understanding population health outcomes and as a lever by which policymakers could intervene to improve population health in their communities.

This analysis shows that counties within EHF's 57-county service area tend to have lower per capita spending on public health and social services than other Texas counties.

Read the complete report

Screen Shot 2018-03-21 at 2.27.30 PM.png
See slides from J. Mac McCullough's presentation

 Link to Texas Local Spending Dashboard

Screen Shot 2018-02-23 at 11.35.57 AM.png

Medical-legal partnerships (MLPs) in Texas are gaining momentum. This report provides a brief overview of MLP activity in Texas to explore the potential for MLP development in health centers in the Episcopal Health Foundation (EHF) service area.

Read the complete report

  • New EHF report: Despite improvements under the Affordable Care Act, Texas still ranks worst in US for “access and affordability” of care

EHF Scorecard analysis cover.png

Despite large gains in the number of Texans with health insurance under the Affordable Care Act (ACA), the state still ranks worst in the nation when it comes to access and affordability of care. That’s according to EHF’s analysis of the Commonwealth Fund Scorecard on State Health System Performance for 2017.

The state’s rock-bottom ranking in access and affordability is likely due to the state’s high number and percentage of uninsured residents. The Scorecard found 23% of adult Texans and 10% of children across the state don’t have health insurance. That’s almost twice the national average for both. In addition, the Scorecard found a higher percentage of Texans were more likely to go without care and say they had high out-of-pocket medical costs than the national average.

Read the complete report

  • New report outlines practical options for Texas communities facing rural hospital closure

Screen Shot 2017-05-22 at 4.07.24 PM.png
COLLEGE STATION – Texas communities facing a rural hospital closure should not solely concentrate on whether or not to close a hospital, but instead focus on the available health resources in the surrounding area. That’s one of the findings of a new report by the Texas A&M Rural and Community Health Institute (RCHI) that examined rural hospital closures and looks at new solutions for rural healthcare concerns. EHF sponsored the report. 

The report found that options like expanding telemedicine, converting a former hospital into a freestanding emergency room, or establishing new rural health clinics are some of the many successful healthcare alternatives available to communities at risk of losing a traditional rural hospital.

Read the complete report

  • New report explores implications of capped Medicaid funding for Texas

Manatt Medicaid report cover.png

A new report released by Manatt Health explores the potential fiscal ramifications of transforming Medicaid through block grants or per capita caps which, for the first time, would create a fixed allocation of federal Medicaid dollars.

For states like Texas, where the majority of funding is for the elderly and for people with disabilities, the promise of greater flexibility may not be enough to compensate for a deep reduction in federal dollars, researchers found.

The report was commissioned by the Texas Alliance for Health Care, a diverse coalition of health care stakeholders including hospitals and physician providers, charitable and health foundations, business leaders and a host of industry experts. EHF is a member of the alliance.

Read the complete report

Screen Shot 2017-03-09 at 2.34.52 PM.png

Researchers say uncertainty about repeal and/or replacement of the Affordable Care Act is contributing to concern

Changing demographics, rural hospital closures and uncertainly about changes to the Affordable Care Act (ACA) are all taking a damaging toll on the ability of Texas rural populations to access health services. Those are some of the findings of a new report by the Texas Organization of Rural & Community Hospitals (TORCH) examining the current crisis facing rural healthcare across the state. EHF sponsored the report.  

The report found that the rural healthcare delivery system in Texas faces declining medical reimbursement rates, rising healthcare costs and closures of 16 rural hospitals since 2013. Those challenges combined with the fact that a growing number of rural residents are aging and battling chronic health conditions is creating an environment that makes it exceedingly difficult for rural populations to maintain good health, researchers say.

The report was co-authored by David Pearson and Quang Ngo at TORCH.

Read the complete report

  • NEW Analysis of Social Determinants of Health screening tools

Screen Shot 2017-02-06 at 9.32.52 AM.pngEHF Analysis of Screening Tools

  • New report: Preventable poor health outcomes for people of color in Texas creates huge economic burden for state

Screen Shot 2016-12-06 at 4.46.25 PM.png

 Researchers estimate health disparities cost Texans $4.6 billion in excess medical spending, lost productivity

Significant health differences for Blacks and Hispanics in Texas lead to higher health care spending, lost work productivity and a dramatic number of years lost to premature death. That’s just a few of the findings of a new study examining the economic burden associated with health disparities across the state. EHF and Methodist Healthcare Ministries of South Texas sponsored the report.

The report found people of color in Texas are less likely to say they’re in good health, more likely to be uninsured, and have higher rates of diabetes and obesity. The report found these and other poor health outcomes cost families, employers, insurers and governments an estimated $1.7 billion in excess medical spending for hospital care, doctor services and prescription drugs.

Researchers estimate health disparities cost Texans $2.9 billion in lost work productivity, primarily because of costs associated with more annual hours off work due to poorer health.

The report also found poor health outcomes lead to a dramatic number of years lost to premature death -- nearly 400,000 lost life years in Texas today, split evenly between Blacks and Hispanics. This loss of life represents an economic impact of nearly $20 billion, the report found.

The report was co-authored by Ani Turner and Erica Munoz-Rumsey of Altarum Institute, Thomas LaVeist of George Washington University, and Darrell Gaskin of Johns Hopkins University.

Read the complete report


Screen Shot 2016-10-31 at 9.08.10 AM.png
Community clinics in Harris County have greatly expanded their services and ability to be a safety net for uninsured and low-income patients, but clinics have serious concerns about enhancing services to better meet the broader needs of those they serve. That’s just one of the conclusions of a new, comprehensive report that surveyed dozens of clinics across Houston and Harris County.

Five Houston-area philanthropic institutions that provide funding for health-related organizations sponsored the report: EHF, The Cullen Trust for Health Care, Houston Endowment, Rockwell Fund and The Simmons Foundation.

The report was co-authored by Jessica Pugil and Kara McArthur with Working Partner, Thomas Reynolds with the Institute for Health Policy at the UT School of Public Health, and Tim Schauer with Cornerstone Consulting Group.

Read the complete report