Investing in factors outside the doctor's office could improve Texans' health and save the state money, according to a report from a group appointed to advise the Texas Legislature.

The "Value-Based Payment and Quality Improvement Advisory Committee" looked at how to treat the health impacts around asthma, food insecurity and housing.

Brian Sasser, chief communications officer with the Episcopal Health Foundation, said it's an important lens to view the big picture - because access to medical care is only about 20% of a person's overall health.

"The rest of the 80% that contributes to their health is all outside the doctor's office," said Sasser. "It's where you live, where you work, the neighborhood you live in. Do you have access to healthy foods? Can you exercise? Do you have money to pay for all this kind of stuff?"

The report was prepared by the Episcopal Health Foundation and the Center for Health Care Strategies. It outlines how non-medical programs now used in some other states could be supported by Medicaid in Texas.

That would include using what's called "in lieu of services" authority to pay for programs that cover non-medical drivers of health, instead of covering only traditional medical care.

Sasser said childhood asthma is one of the best examples of how doctors can only do so much.

"If you're a child with asthma, Medicaid and other payers will continue to cover and pay for breathing treatments, ER visits, doctor's visits," said Sasser. "But what they won't pay for right now is for someone to go to your house, determine what's causing your asthma inside your house and taking care of it."

According to the study authors, reviews by the Centers for Disease Control and Prevention show for every dollar invested, projects returned anywhere from $5 to $14 in overall savings.

Sasser said that would require a twofold shift in Texas.

"So, if we can just shift a little bit of that mindset and a little bit of the money," said Sasser, "from only covering medical care and sick care - and shift that 'upstream,' it'll improve health and it'll save money."

Another successful non-medical program cited in the report includes "food as medicine" projects, such as medically-tailored meals for people with diabetes and other chronic illnesses.

A new report on lung cancer by the American Lung Association showed Maryland has quite a bit of room to improve diagnoses and treatment but experts said the state has taken some big steps in tackling it.

The report showed almost 17% of Marylanders at high risk for lung cancer were screened, a little less than the national average. Maryland fared better in other metrics, including lower rates of adult smokers and people unable to access treatment.

Aleks Casper, Maryland director of advocacy for the American Lung Association, said to improve the state's standing, Marylanders at risk of lung cancer need to be screened at higher rates.

"If we can get people screened, our chances of impacting all the other metrics improve," Casper explained. "If we get people screened and we can find it early, then we can connect them to treatment and we can connect them to surgery, which impacts outcomes."

The report also noted Latinos in Maryland are the least likely group to be diagnosed early.

Casper pointed out certain policies in Maryland have removed barriers to diagnosis and treatment. Just this year, Maryland became one of 15 states to require insurance to cover biomarker testing, including for lung cancer. The National Cancer Institute described biomarker testing as using a sample of tissue, blood or other fluid to look for genes or chromosomes which could increase a person's likelihood of developing certain cancers, which Casper emphasized is critical.

"Being able to test and determine what the best type of treatment for that person's disease, that kind of really individualized care and giving people access to that, is really important," Casper added.

Those who want to find out if they're eligible to be screened for lung cancer can take a quick test at savedbythescan.org.


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By Kyla Russell for WISH-TV.
Broadcast version by Joe Ulery for Indiana News Service reporting for the WISH-TV-Free Press Indiana-Public News Service Collaboration

Walking pneumonia cases in central Indiana have seen a steep increase in recent weeks, local physicians say.

"But what we've seen this summer, starting in July and August, was an explosion in the number of cases," said Dr. John Christenson, associate medical director of infection prevention at Riley Hospital for Children. "Some require admissions to intensive care units. Children die, adults die .. sometimes it invades the brain and it can cause an infection there."

Walking pneumonia is generally considered less severe than pneumonia, but can have lasting impacts if not caught early on. The disease is caused by mycoplasma pneumoniae, which can damage the lining of the respiratory tract, according to the CDC.

It is spread through droplets released when someone coughs or sneezes.

"Symptoms can begin mildly with sore throat, cough, or chest pain," Christenson said.

About two million people are diagnosed with the disease each year. This year is different, though.

While it's common for young children and adolescents to be impacted, small children born during the Covid-19 lockdown are seeing a surge in cases.

The CDC said diagnoses in kids between two and four years old jumped from 1% to 7.2% over a six-month time span this year.

"We saw a rebound after Covid," Christenson said.

During lockdown, people were wearing masks, staying home, and were not at school and work.

"What happened was a lot of people who could acquire an infection around that time, didn't," Christenson said. "So, now they're all susceptible. You bring in a new germ or an old germ into an environment and it spreads like wildfire."

Several local schools have seen an increase in students, asking parents to be on the lookout for symptoms and to take their child to a physician if needed.

As holiday gatherings begin, Christenson is heeding a similar call, especially in severe cases.

"That's when you need to take them to their healthcare professional to have them seen, and in some cases, get X-rays," Christenson said.

Additionally, Christenson said it is important to make sure families are up-to-date on all vaccinations.


Kyla Russell wrote this article for WISH-TV.


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More than one in three children is now overweight or obese, according to new research published in the Lancet medical journal.

The study found while Kentucky and other southern states are forecast to continue seeing rising levels of childhood obesity, some other states, such as Utah, will experience even higher spikes.

Ben Chandler, CEO of the Foundation for a Healthy Kentucky, said the Commonwealth is struggling to address health care and quality of life for kids.

"I think we're 45th in being overweight," Chandler observed. "It leads to a shorter life expectancy. It leads to tremendous spikes in the odds of getting any number of diseases and it has a huge cost attributed to it. "

Almost half of teens and young adults now are either overweight or obese, compared with 29% in 1990. The number is expected to jump by between 31% and 50% for adolescents, and by 29% to 33% for kids ages 6-11.

Chandler argued the state should increase funding for physical activity programs in schools and address the persistent lack of access to healthy and affordable fresh food. He added the issue cannot be tackled solely through individual behavior changes.

"There are a lot of environmental factors that are involved here," Chandler pointed out. "There's a lot of money, quite frankly, being spent in advertising for things that are bad for you."

The study also found among U.S. adults, if the current pattern continues, more than 250 million people will be overweight or obese by 2050.