Smith County Commissioners Court approved a change to its employee health plan and authorized the Sheriff’s Office to apply for a state grant on Tuesday, October 20, 2026. These decisions, made during their weekly meeting, aim to reduce costs and streamline operations for the county. The court also discussed the imminent hiring of a new budget officer.
Effective January 1, 2027, Smith County will switch its reference-based hospital claim repricing services to Advanced Medical Pricing Solutions (AMPS). The move was recommended by Brinson Benefits, the firm managing the county's employee health plan, after reviewing four potential vendors. Dawn Brinson, CEO and founder of Brinson Benefits, stated that AMPS was chosen as the "front runner for reasons of savings and fees." AMPS has been in business for 21 years and prices hospital bills based on a percentage above Medicare.
Brinson reported that AMPS identified approximately $2.8 million in potential medical claim savings based on a review of the county's 2025 claims data. Additionally, AMPS offered about $456,000 in annual administrative fee savings compared to the county's current provider, Claritev. An estimated $700,000 to $800,000 in further savings could be realized through AMPS's enhanced claim line-by-line review service, which works to identify improper billing and unsupported charges before repricing occurs. The transition to AMPS will also involve moving the county’s Hill Smart Network relationship to the new provider, which may mean foregoing some existing direct hospital contracts for the sake of improved pricing.
The change will require every Smith County employee and their dependents to obtain a new identification card. Brinson noted this could be challenging, as the new cards will feature a different claims address, requiring local healthcare providers to update where they send claims. Commissioner John Moore voiced concerns about the risk of balance billing, collection actions, and the possibility of employees being caught between providers and the health plan. Chief Human Resource Officer Esmeralda Corona acknowledged that balance-billing issues can occur with reference-based pricing but affirmed the human resources department's commitment to assisting employees with billing disputes and working directly with hospital administrators. Commissioner Franklin reassured the court that the goal is to support employees, stating, “I can reassure you Commissioner that if indeed we have any issue with the hospital administrations, anything like that, that we can sit down on the table and talk through it.” AMPS has reportedly verbally agreed to a performance guarantee, putting 20% of its fees at risk if it fails to achieve the projected savings, though this agreement remains under legal review.
In other action, the Commissioners Court approved the Smith County Sheriff’s Office to apply for The Office of Court Administration (OCA) Public Safety Report System (PSRS) API Integration Grant. This is a reimbursement grant program funded by the Texas Legislature, designed to help Texas counties connect their jail or case management systems to the state’s Public Safety Report System. Chief Deputy Gary Pinkerton explained that the integration would automate the process where Justices of the Peace are required to warn inmates about felony or Class A misdemeanor charges, eliminating manual data entry. He said that once a person is booked into jail, the system would already have their information, speeding up the process. The Texas Association of Counties highlights that this grant eliminates manual, double-entry of data, accelerates the exchange of approved information, and promotes data consistency for bail-setting and public safety reporting mandated under Senate Bill 6. Odyssey Case Manager through Tyler Technology would assist the state agency with this integration, and the reimbursement cost deadline for the grant is August 2029.
Finally, the Commissioners Court heard an announcement regarding a new budget officer. Chief Human Resource Officer Esmeralda Corona stated that an offer of employment would be extended this week to an unnamed candidate who was interviewed on Tuesday. This individual will assume the role previously held by Timothy Hollis, who had taken on both the auditor and budget officer positions following the resignation of former auditor Karin Smith in June.
The new employee health plan is scheduled to take effect on January 1, 2027. The Sheriff's Office will proceed with its grant application, with the integration deadline set for August 2029. The county anticipates making an offer to the prospective budget officer this week.
