Texas' health plans have long benefitted from the Lone Star State's mandatory generic dispensing law, but have gone beyond that to achieve significant generic utilization and subsequent savings from that. Texas has never been a big HMO state, but the players will keep going because the winnings are substantial, with all but one posting improved profits in 2007. More plans are moving to integrate dental and medical health information, with the Texas Blue plan, Humana and Aetna leading the charge. And Texas is moving into the forefront of the telehealth movement, led by the University of Texas Medical Branch. And in a state where the gulf is huge between the wealthy and the poor, plans are struggling to deal with the new trend of "concierge medicine," for those who can afford to "retain" doctors.