Since the 2011 creation of Texas’ Medicaid 1115 Waiver, the hospital Uncompensated Care (UC) payment program has made more than $38 billion in payments potentially available to offset some of the unreimbursed charity care costs for Texas’ public and private hospitals. Teaching Hospitals of Texas (THOT) members provide this care through comprehensive, integrated systems of care with most of it being outpatient preventive, primary and specialty care.