About TMA Related Organizations TMA Calendar Site Map Contact Us

Monday, January 30, 2012

NIELSEN: PHYSICIANS MUST LEAD INNOVATION

Physicians must take the lead in driving innovations that make the U.S. health care system more efficient and effective, Nancy Nielsen, MD, senior adviser to the Center for Medicare and Medicaid Innovation, told the TMA 2012 Winter Conference. "We need a payment system that keeps physicians in practice," Dr. Nielsen said. "We're seeking ideas that make sure we do coordinated care better." For more information and to submit your ideas, go to http://innovations.cms.gov/. Other highlights of this past weekend's meeting:

  • I don't know if there's an ICD-10 code for "fed-up physician," but I do know that the new system has 480 codes for a fractured patella – up from a grand total of two in ICD-9 – and that YO411XA is the ICD-10 code for "assault by human bite, initial encounter." I learned that from our speaker, Dennis Flynt, who called ICD-10 "the most significant change in how you conduct business in 25 years. … Productivity will go down as you learn a whole new language." TMA is working with Mr. Flynt's firm to provide you with training and tools to help you make the transition before the Oct. 1, 2013 deadline.
  • 58 elected leaders and dedicated staff from 21 Texas county medical societies shared their greatest fears and highest hopes for the year at our annual grassroots leadership forum.
  • TEXPAC political consultant Bryan Eppstein predicted the 2012 presidential tickets would be Mitt Romney and U.S. Sen. Marco Rubio (R-Fla.) for the GOP vs. President Obama and Secretary of State Hillary Clinton on the Democratic side.

HUSBAND-WIFE TEAM TAKE OVER IN BEXAR

For the first time in the Bexar County Medical Society's 159-year history, a physician and his spouse are leading the society and the Bexar County Medical Society Alliance. Infectious disease specialist Robert Trevino Jr., MD, is the new medical society president. He takes over from otolaryngologist Jesse Moss Jr., MD. Lisa Trevino is the new alliance president.

SOUTH TEXAS MOBILE MEDICAL PROGRAM NAMED TMAF CHAMPION

The TMA Foundation (TMAF) presented its 2012 John P. McGovern Champion of Health Award to a Corpus Christi-area program that provides free primary care services from a 40-foot mobile clinic. Staffed by volunteer physicians and others, the Mission of Mercy van has recorded more than 11,000 patient visits in four years. More than half of the patients suffer from chronic illnesses. The Baylor College of Medicine's Teen Health Clinic, which provides prenatal and family planning care and treats sexually transmitted diseases for more than 10,000 uninsured minority youth in the Houston area, was named the secondary winner. TMAF President Russ Kridel, MD, presented the awards at the TMA Winter Conference. The award is named after the late John P. McGovern, MD, of Houston, whose generous support finances the $5,000 award for the winning program and a $2,500 grant to the secondary winner. TMAF also honored a pair of new Major Donors, whose cumulative giving has exceeded $10,000: Austin King, MD, and State Rep. Susan King (R-Abilene); and Dr. Kridel and his wife, Cheryl. You can now donate online to TMAF. Please give today.

TMA JOINS AMA CALL TO "CLEAN THE BOOKS" ON THE SGR

American Medical Association President Peter Carmel, MD, brought a new Medicare advocacy campaign with him to Texas. Dr. Carmel met with physicians in Beaumont and key health care reporters in Austin before speaking at the TMA Winter Conference. TMA and state associations and specialty societies have signed on to the AMA's call to use savings from the Iraq and Afghanistan wars to pay off the Sustainable Growth Rate's $300 billion debt and stop the March 1 Medicare pay cut of 27.4 percent. "Using funds that will not be needed as the wars wind down to protect health care for men and women in uniform and our nation's seniors is the fiscally responsible thing to do," the societies wrote to congressional leaders. "By eliminating this failed formula once and for all, Congress can stop growing the size of the problem for patients, physicians, and taxpayers."

NATIONAL HIT COORDINATOR MEETS WITH TMA TEAM, TEXAS RECS

TMA's Ad Hoc Committee on Health Information Technology (HIT) and the boards of the four Texas HIT regional extension centers received a small reward for their years of working to help Texas physicians prepare for and implement HIT. Farzad Mostashari, MD, President Obama's national coordinator for HIT, met with the Texans in a whirlwind Austin tour just days after making national headlines with his prediction that 100,000 physicians and providers will earn Medicare or Medicaid incentives this year for reaching meaningful use of electronic health records.

GOVERNOR PERRY APPOINTS THREE TO TEXAS MEDICAL BOARD

Belton surgeon William "Roy" Smythe, MD, is one of three members Gov. Rick Perry named to the Texas Medical Board. Dr. Smythe is medical director for Scott and White Healthcare's Office of Innovation and a professor and chair of surgery at the Texas A&M Health Science Center College of Medicine. The governor also appointed Fort Worth businessman Carlos Gallardo and reappointed Paulette Southard, of Alice, a retired teacher and community volunteer.

Monday, January 23, 2012

QUESTIONS OUTNUMBER ANSWERS IN TEXAS 2012 ELECTIONS

When we planned the program for this week’s 2012 TMA Winter Conference months ago, we expected the state’s primary elections to be well under way by this time and thought Gov. Rick Perry could be battling for the GOP presidential nomination. This past week’s events — with the U.S. Supreme Court throwing out the state’s newest election boundaries and Governor Perry exiting the campaign — threw yet another monkey wrench into our plans. All of that, though, will make the closing panel discussion at Saturday morning’s session that much more interesting. Bring your best questions for TMA political consultant Bryan Eppstein and our lobby team to answer. Here are a few I might ask:

  • What does the uncertainty over new district lines mean for physician and alliance incumbents running for the Texas Legislature and Congress?
  • What is the outlook for the state Senate bids by State Reps. Charles Schwertner, MD (R-Georgetown), and Mark Shelton, MD (R-Fort Worth)?
  • How are newcomers Sonal Bhuchar (R-Sugarland), Greg Bonnen, MD (R-Friendswood), and Susan Todd (R-Fort Worth) faring so far?
How will the governor’s experience on the national campaign trail affect Texas politics?

SGR FIX STILL LOOKS MURKY

Congress watchers probably weren’t surprised by the contradictory messages coming out of Washington on the prospects to stop the 27.4-percent cut in physicians’ Medicare payments set to hit on Feb. 28. On Tuesday last week, The New York Times reported that congressional leaders were “confident” a solution to the political gridlock would soon emerge. Then on Thursday, Kaiser Health News said “no easy fix” was in the offing. While I’m more inclined to believe the latter analysis, the message to physician organizations is that we can’t let up on the pressure. I’m sure American Medical Association President Peter Carmel, MD, will share his views on that from the winter conference stage on Saturday. In the meantime, I encourage you to take another look at the excellent TMA animated video Grandma and the Big, Bad SGR. Share it with your colleagues, friends, family, staff, patients … and our two U.S. senators and your representative. In just six weeks, the video garnered more than 5,000 views on YouTube.

FOUNDATION TO PREPARE BLUEPRINT FOR AMERICAN HEALTH CARE

The board of the Physicians Foundation, on which I serve as president, voted to commission a “Blueprint for American Health Care” that will outline “what the American health care system should look like from the physicians’ and patients’ perspective.” The foundation, created by some of the proceeds of our antiracketeering lawsuits against the country’s largest for-profit health plans, is the perfect vehicle to develop this post-health care reform outline of where U.S. health care should go. I expect the blueprint will, among other things, follow the TMA strategy of identifying what was missing from the Affordable Care Act, what needs to stay, and what needs to go. I’ll share the final document with you as soon as it is complete.

DALLAS, EL PASO COUNTY SOCIETIES INSTALL NEW LEADERS

TMA President Bruce Malone, MD, was in El Paso and Dallas last week to celebrate the installation of new leaders at the county societies there. Cardiologist Rick Snyder, MD, is the Dallas County Medical Society’s (DCMS’) 129th president. He replaces orthopedic surgeon Shelton Hopkins, MD. DCMS also presented the Charles Max Cole, MD, Leadership Award to Robert W. Haley, MD, and the Millard J. and Robert L. Heath Award to U.S. Rep. Pete Sessions (R-Dallas). Dr. Malone administered the oath of office to the El Paso County Medical Society’s 2012 president, Bruce Applebaum, MD. The general surgeon succeeds obstetrician-gynecologist Jose Aun, MD.

TMA ENGAGED IN NATIONAL CANCER RESEARCH STUDY

TMA is working with the American Cancer Society to enroll patients in a huge new national study, the CPS-3, to help researchers better understand the lifestyle, environmental, and genetic factors that cause or prevent cancer. The TMA building will be one of two Austin intake sites in late February and early March. We also are promoting the study statewide. Dr. Malone will join a news conference next week to announce the project. “TMA has supported the cancer community for more than 20 years,” Dr. Malone said. “Please encourage your patients to enroll in this landmark study. It will allow us to explore new and emerging hypotheses related to cancer. With your help, we can work toward eliminating cancer as a major health concern for future Texans.”

Tuesday, January 17, 2012

NEW LEADERS TAKE REINS AT AMERICA'S LARGEST COUNTY MEDICAL SOCIETY

TMA President Bruce Malone, MD, was on hand as organized medicine in Houston installed a new slate of leaders. Ophthalmologist Keith Bourgeois, MD, is the new president of Harris County Medical Society. He replaces Guru Reddy, MD, a gastroenterologist. Internist Elizabeth Torres, MD, is the incoming president of the Houston Academy of Medicine. Humorist and former gubernatorial candidate Kinky Friedman was the keynote speaker. TMA President-Elect Michael Speer, MD, was master of ceremonies. Dr. Speer was the keynote speaker himself the night before at the Fort Bend Medical Society’s first meeting of the year. Physicians there earned an hour of continuing medical education credit from the lecture, “Electronic Health Records: New Implications for Charting, Reimbursement, and Liability,” sponsored by Texas Medical Liability Trust.

TMA CLOSES THE YEAR 500 MEMBERS STRONGER

In a tough economy, where medical societies around the country are struggling to remain relevant, TMA ended 2011 with 45,548 members, a gain of more than 500 from the year before. Being America’s largest state medical society isn’t just a numbers thing for us. Through our TMA of the Future project, headed by the TMA Board of Trustees, we intend to provide value that far outstrips the cost of membership. Frankly, in this time of unrivaled change in health care, we think belonging to TMA and your county medical society should be an outright necessity for every Texas physician. Not sure what you’re getting for your dues dollar? Check out our interactive dues ROI calculator. And if you haven’t paid your 2012 dues yet, it’s easy online.

STILL TIME TO REGISTER FOR WINTER CONFERENCE

Don’t miss an exciting array of presentations and learning opportunities at the 2012 TMA Winter Conference. The keynote speaker is Nancy Nielsen, MD, senior adviser to the Center for Medicare and Medicaid Innovation. Along with a full slate of TMA board, council, and committee meetings, there’s a dawn duster on the fundamentals of billing for and supervising nonphysician providers, an ICD-10 update, a sneak preview of the 2012 primary elections, and three space-limited TMA Social Media Lab sessions. Register today.

STATE CONSIDERING SOME CHANGES FOR DUAL-ELIGIBLES

The Texas Health and Human Services Commission (HHSC) is willing to make adjustments to its new policy of not paying coinsurance and deductible payments for Medicare Part B services for patients eligible for both Medicare and Medicaid, Billy Millwee, deputy executive commissioner for health services, told a group of physician leaders at a meeting that TMA coordinated. Mr. Millwee said HHSC will examine where the new policy has created specific access problems for patients of some specialties — such as oncology, where the charges for chemotherapy substantially skew the total cost of care. However, to reduce the size of the cut, HHSC will need specialty societies to help identify Medicaid cost savings to help offset any changes to the new policy. Mr. Millwee said the Texas Legislature charged the commission with saving nearly $300 million via this policy change, and HHSC has no authority to reverse course broadly. Dr. Malone and Carlos Cardenas, MD, represented the TMA Board of Trustees at the meeting, which also included physician leaders from anesthesiology, ophthalmology, radiology, emergency medicine, oncology, internal medicine, orthopedics, allergy/immunology, and the Border Health Caucus. Texas needs a long-term solution to the high cost of caring for the “dual eligibles.” There is no financial incentive for states to improve continuity of care for these patients since the majority of any savings would accrue to the federal government, which pays for their acute-care services. A couple of states have shown significant savings through a federal waiver that promotes stronger case management for these patients. The federal government is considering additional pilot programs that would allow states and the federal government to share in any cost savings by improving care for dual eligibles.

CARDIOLOGISTS: LET'S BE BOLD ENOUGH TO GO FOR IT

I had the opportunity to watch another top-notch medical society plan for the future at the American College of Cardiology’s (ACC’s) annual Leadership Development Conference. More than 500 cardiology leaders from around the country gathered to figure out how to help their colleagues make the most of changing circumstances. “Better health care at lower per capita costs; that really sounds trite, but it’s the challenge or opportunity or nightmare in front of us,” said my old friend Jack Lewin, MD, CEO of ACC. “Our message this week was: Let’s be bold enough to go for it.”

Monday, January 9, 2012

PHYSICIANS' MEDICARE PAY IN LIMBO AS CONGRESS MUDDLES ONWARD

New Year’s Day has come and gone, and physicians’ Medicare payments have once again been spared the immense cuts driven by the Sustainable Growth Rate (SGR) formula. At least through Feb. 28, your Medicare payments will be close to what they were last year. And the government now says you have until Feb. 14 to decide whether to participate in Medicare this year. A longer-term patch or even a permanent replacement for the SGR remains tied tightly to the ongoing partisan showdown over the payroll tax cut and extension of unemployment benefits. As part of the pre-Christmas compromise, a 20-member congressional conference committee that includes Rep. Kevin Brady (R-The Woodlands) will try to negotiate a package that extends beyond the end of February. The American Medical Association continues to call for total repeal of the SGR. “It is irrational to invest more taxpayer money to support a policy that is a proven failure,” says an AMA strategy memo. “A two year patch will cost $39 billion and increase the cost of future efforts to repeal the SGR by an additional $56 billion and increase the projected cut in 2014 to 36 percent.”

USING A NONPHYSICIAN PROVIDER IN YOUR PRACTICE? DO IT RIGHT

Do you employ a nonphysician provider (NPP)? Thinking about hiring one? TMA’s half-day, statewide seminar series, Nonphysician Providers: Fundamentals of Billing and Supervision, begins Feb. 15. Laura Palmer, FACMPE, of TMA Practice Consulting will help you avoid legal pitfalls, bill correctly, give patients more access to care, create a “team care” approach, and supervise and delegate correctly. See the TMA website or call (800)880-7955 to register.

TEXAS REDISTRICTING CASE IN SUPREME COURT TODAY

The U.S. Supreme Court is hearing oral arguments today over the maps drawn for Texas’ legislative and congressional districts. The new “temporary” court-ordered primary election date is April 3. This could be further delayed depending on what the high court and two other federal courts decide. Alternative primary election dates include late April and late May. Until the federal courts adopt final maps, the entire primary election cycle is virtually frozen. In the meantime, TEXPAC is asking physician leaders to meet with their local state representatives and senators, and with their U.S. representatives to discuss key issues and continue building relationships. With a record number of physician and alliance candidates on the ballot this year, we can’t wait for the campaigns to begin in earnest.

HOT ISSUES ON TMA BOARD AGENDA

Payment for emergency room services, the state’s plan for dual-eligible (Medicare and Medicaid) patients, TMA’s public health priorities, and our work enhancing state societies’ impact in Washington are all on the agenda for the Board of Trustees meeting later this month at the 2012 TMA Winter Conference in Austin. Registration is still open for the Jan. 27-28 event that includes:


  • A keynote address from Nancy Nielsen, MD, on the latest in care and payment innovation. Dr. Nielsen is the senior adviser to theCenter for Medicare and Medicaid Innovation;
  • An ICD-10 update;
  • A sneak preview of the 2012 primary elections;
  • A dawn duster on the fundamentals of billing for and supervising nonphysician providers; and
  • Three space-limited TMA Social Media Lab sessions to teach you how to take advantage of social media tools like Facebook, YouTube, Twitter, and LinkedIn.

NEW TMLT PROGRAM REWARDS LOYAL POLICYHOLDERS WITH FUTURE DOLLARS

The Governing Board of Texas Medical Liability Trust (TMLT) has set aside $100 million for a new program that rewards loyal policyholders. The TMLT TrustRewards Program will pay participating physicians when they retire or meet other qualifying milestones. This is the latest in TMLT’s long history of rewarding covered physicians through rate reductions, dividends, and surplus returns. Only TMA members are eligible for TMLT liability coverage.

NEW AND UNDERREPORTED NEWS ITEMS

Here are a few stories that crossed our radar over the weekend and during the holidays: