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Monday, January 28, 2013

NEWSHOUR TRAVELS TO AUSTIN TO STUDY PHYSICIANS' MEDICARE CRISIS

In the year 2000, 78 percent of Texas physicians opened their practices to all new Medicare patients. Twelve years later — thanks to congressional dithering on Medicare payments and thousands of pages of onerous new regulations — that figure is down to 58 percent. That’s the basic message I shared with Betty Ann Bowser, health correspondent for PBS NewsHour, who came to Austin for a story about why more and more physicians can no longer take new Medicare patients. She also interviewed Austin Regional Clinic founder Norm Chenven, MD, and internist Howard Marcus, MD.

A WARM WELCOME TO NEW COUNTY MEDICAL SOCIETY PRESIDENTS

County medical societies around the state are installing new presidents and boards this month. TMA President Michael Speer, MD, traveled to three of them in the past 10 days. At the El Paso County Medical Society, Dr. Speer gave the oath of office to nephrologist Patricio Pazmino, MD. Dr. Speer used the occasion to give El Paso physicians a half-dozen great selling points to recruit their colleagues to join TMA. In his hometown of Houston, Dr. Speer attended the installation of facial plastic surgeon Russ Kridel, MD, as the 2013 president of the Harris County Medical Society and otolaryngologist Bradford Patt, MD, as the new president of the Houston Academy of Medicine. I joined Dr. Speer at the Dallas County Medical Society ceremonies. Radiologist Cynthia Sherry, MD, is the society’s 130th president. Dallas physicians honored two men for their role in responding to last year’s West Nile virus outbreak, giving the Charles Max Cole, MD, Leadership Award to James L. Luby, MD, and the Millard J. and Robert L. Heath Award to Dallas County Judge Clay Jenkins.

"WE WERE TEAM BEFORE TEAM WAS COOL"

 What’s your vision of scope-of-practice expansion? Better team-based care under the supervision of a physician? Or potentially unsafe independent practice for allied health practitioners? TMA supports the former and vehemently opposes the later. We met to discuss legislative strategies with Lauren Dobbs, president of the Texas Academy of Physician Assistants, which has adopted the slogan, “We were team before team was cool.” That’s consistent with our legislative agenda: “Texas law clearly defines the practice of medicine and the educational qualifications necessary to diagnose, independently prescribe, and direct patient care — and to be held accountable for that care. Now, and in the future, physicians and other professionals will practice in teams to provide comprehensive patient care, and these patient-focused teams must be physician-led to ensure quality, continuity, and efficiency in care.” Read more in Healthy Vision 2020.

PFLUGERVILLE PRACTICE JOINS AMA PHYSICIAN SATISFACTION STUDY

Parkway Primary Care in Pflugerville, just north of Austin, is one of a handful of practices around the country participating in a study aimed at stopping physician burnout and rediscovering the “joy in practice.” We met with family physicians Shane E. Keller, MD; Tina J. Philip, DO; and Travis G. Bias, DO, who we nominated to be part of the American Medical Association’s research project. AMA is working with practices of different sizes and settings to identify those factors that can or do lead to increased physician satisfaction.

COMMISSIONER JANEK HEADLINES TMA WINTER CONFERENCE

Texas Health and Human Services Commissioner Kyle Janek, MD, will take the hot seat to discuss his plans for the state Medicaid program and covering the uninsured. Former U.S. Census Bureau Director Steve Murdock, PhD, will share his deep insights on demographics changes in Texas and the implications for medicine. The chief of family medicine at Kelsey-Seybold Clinic in Houston will explain how and why the venerable multispecialty practice became the first nationally accredited accountable care organization. All of this plus leadership meetings and our popular Social Media Lab await you this weekend at 2013 TMA Winter Conference in Austin. I hope to see you there.

COME TO FIRST, FIRST TUESDAY NEXT WEEK - FEB. 5


Next Tuesday’s first First Tuesdays at the Capitol for 2013 marks the 10-year anniversary of the nation’s best grassroots physician lobbying program. Launched as part of our drive for health care liability reforms in 2003, First Tuesdays has become an integral part of our legislative advocacy operations. State lawmakers look forward to the “white coat invasion” four times each session. Hundreds of TMA and TMA Alliance members have become veteran lobbyists for a day, now quite comfortable calling on their representatives and senators or testifying before a committee. Medical students have used First Tuesdays as a springboard to greater involvement with TMA as today’s young physicians. Put a big Texas star on your calendar for Feb. 5, March 5, April 2, and May 7. Watch the short video, then sign up online or contact your county medical society.

Tuesday, January 22, 2013

DRAFT STATE BUDGETS LEAVE CASH ON THE TABLE

If the first budget drafts from state House and Senate leaders are any indication, state lawmakers this year won’t be rushing to fill the spending cuts they made in 2011. State Comptroller Susan Combs told legislators they’d have about $101.4 billion in state funds to use for the 2014-15 budget, along with an extra $11.8 billion in the Rainy Day Fund. But Senate Bill 1 and House Bill 1, the draft budgets introduced respectively by Senate Finance Committee Chair Tommy Williams (R-The Woodlands) and House Appropriations Committee Chair Jim Pitts (R-Waxahachie), each would spend only $89 billion in state funds for the two-year budget cycle. Unlike last session at this point, we’re not facing huge cuts in Medicaid payments, public health, and medical education. But the spartan drafts we’re looking at now fill in few of the holes lawmakers left in the current budget. One bright spot: a proposed big increase in physician loan repayment programs. Watch the TMA Legislative News Hotline video with TMA lobbyists Patricia Kolodzey and Troy Alexander discussing the budgets and other highlights from under the dome.

PHYSICIANS FOUNDATION TACKLES RED TAPE

The board of The Physicians Foundation (PF) spent its first meeting of the year talking about what shouldn’t be and what shouldn’t have been. Our red-tape reduction paper lists 10 health care regulations that have no value but cause hassle and cost practices money. Our “Blueprint for American Health Care” discusses what health system reform should look like if physicians had written the law. Both documents will be invaluable for TMA and other organizations as we lobby Congress for physicians. The PF board also awarded 17 physician leadership grants totaling $1.7 million, and contracted for continued review and evaluation of the president’s health reform law.

DOCTOR-SENATORS EARN KEY COMMITTEE POSTS

State Sen. Bob Deuell, MD (R-Greenville), kept his spots as vice chair of the Senate Health and Human Services and State Affairs committees, and as a member of the Senate Finance Committee; rookie Sen. Charles Schwertner, MD (R-Georgetown), won a seat on Health and Human Services; and new Sen. Donna Campbell, MD (R-New Braunfels), was appointed to the Senate Education Committee. Those are the highlights for the three TMA members in the Senate as Lt. Gov. David Dewhurst made his committee appointments late last week. As previously announced, Senator Williams is the new chair of the Finance Committee, and Sen. Jane Nelson (R-Flower Mound) stays at the helm of the Health and Human Services Committee. House Speaker Joe Straus (R-San Antonio) is expected to release his committee appointments by next week.

DATES FOR PHYSICIAN ACTIVISTS TO REMEMBER


If these Austin events aren’t on your calendar, they should be:
  • Feb. 1-2: TMA Winter Conference — Speakers include new Health and Human Services Commissioner Kyle Janek, MD; American Medical Association President Jeremy Lazarus, MD; and former state demographer Steve Murdock, PhD. County medical society presidents and presidents-elect, don’t miss Saturday afternoon’s 2013 County Medical Society Leadership Forum; this Friday is the registration deadline.
  • Feb. 5, March 5, April 2, May 7: First Tuesdays at the Capitol — The “White Coat Invasion” has been the key to our successes in the Texas Legislature since the inception of First Tuesdays at the Capitol in 2003. Our senators and representatives listen when their hometown doctors appear in their offices. Our influence is so much greater when physicians and alliance members arrive en masse in the House and Senate galleries. Be there for one, two, or all four!
  • April 4-5: Texas Health/Medical Home Summit — This is the first statewide conference focused on expanding access to a health/medical home for individuals and families in Texas. This summit offers stakeholders the opportunity to learn about medical home models and best practices and to interact with program experts at various stages of implementation.

WHAT TO DO FIRST IN ICD-10 PREPARATION


Don’t let the Oct. 1, 2014, implementation date lull you into complacency. As we’ve worked to convince the feds for years now, switching to the new ICD-10 coding system will be a lot of work for physicians’ practices. Get a head start on the planning process at noon Central Time on Jan. 30 with TMA’s live webinar, ICD-10 Starts With Physicians: A Primer for Beginning the Process. You’ll get an overview of the new coding standard, learn the differences from ICD-9, and pick up direction for the first steps you should take. I also suggest you watch the first of our free ICD-10 video series, in which TMA Practice Management Consultant Heather Bettridge sits down with Steve Arter, the chief executive officer of Complete Practice Resources (CPR), and CPR President Denny Flint to get their take on the key steps physicians should be taking now.

Monday, January 14, 2013

TMA AND THA BOARDS FOCUS ON MEDICAID

Led by TMA Board of Trustees Chair Tom Garcia, MD, members of our board met with board members from the Texas Hospital Association (THA) to discuss issues both organizations face during the 83rd Texas Legislature. Both agreed on the need for greater collaboration between physicians and hospitals in the face of significant changes to the health care environment. Much of the discussion focused on the state budget and Medicaid. Although the state is in a significantly better financial position than last session, the expected emergency appropriation of $4.5 billion in additional Medicaid spending will make it challenging to secure additional dollars during the session. Other joint Medicaid priorities include reversing the dual-eligible cut, 1115 waiver implementation, and difficulties with the Office of the Inspector General. We spoke about Medicaid expansion and the need to identify what the legislature could do to provide better coverage and access to this patient population. The groups also discussed the importance of identifying resources to fund graduate medical education and agreed that TMA and THA need to work with the medical schools to find opportunities to grow residency slots. Finally, the two boards discussed numerous health insurance issues, ranging from pricing transparency to silent PPOs to standardizing preauthorization requirements. We agreed to keep in close contact during the session and to reconvene after the completion of bill filing in March. The TMA team also included President Michael E. Speer, MD; President-Elect Steve Brotherton, MD; Immediate Past President Bruce Malone, MD; House Speaker Cliff Moy, MD, and Vice Speaker Susan Strate, MD; and board members Drs. Carlos Cardenas, Lewis Foxhall, David Henkes, Austin King, and Dan McCoy.

LEGISLATIVE SESSION OPENS WITH BETTER BUDGET NEWS, MORE DOCTORS IN THE HOUSE

Just like 2011, the Texas Legislature convened this year with a host of new members filling the chairs and House Speaker Joe Straus (R-San Antonio) easily winning reelection. But unlike two years ago, when lawmakers had the challenge of balancing the state budget with a $27 billion shortfall, the budget picture is now much brighter. Comptroller Susan Combs is forecasting an $8.8 billion surplus for this budget cycle; she said lawmakers should have $101.4 billion to spend for the 2014-15 biennium. The budget surplus could go fast as legislators have to contend with a $4.7 billion shortfall in the current Medicaid budget before they start tackling the next two-year budget. And Gov. Rick Perry told lawmakers the rosier budget picture should make them start thinking of tax relief rather than increased spending. “For the sake of all Texas taxpayers, we must control the appetite for more spending,” he said. In this video edition of TMA Legislative News Hotline, TMA lobbyists Darren Whitehurst and Dan Finch discuss what it means that a record eight physician and TMA Alliance members took the oath of office at the start of the 83rd session.


 

GROUP PRACTICE LEADERS SHARE CONCERNS

Dr. Speer hosted several discussions — in person and by conference call — with leaders of groups that pay for 100 percent of their physicians to join TMA and our county societies. A benefit of 100-percent membership, these ongoing meetings help us to understand the challenges groups face and their advocacy priorities, and to determine how we can best meet those needs. Not surprisingly, the issues of concern are familiar ones; they include reduced payments, growing overhead expenses, an ever-increasing regulatory burden, endless paperwork, and other practice hassles and public health concerns. We also shared our newest and most innovative products and services, including those that can help large practices thrive in an “accountable care” environment.

MSO TASK FORCE SEEKS SERVICES PHYSICIANS NEED

As follow-up to our Design Shop on TMA of the Future, TMA leaders and staff continue to evaluate how best to provide physicians and groups the services they need to participate in value-based environments of care. The Management Services Organization Task Force, chaired by Dr. McCoy, will meet on Feb. 2 to continue the development of this business model.

TMA MEMBERSHIP HITS 47,000 MILESTONE

When we closed the books on last year, the number of TMA physician and medical student members passed yet another benchmark, ending at 47,033. That means TMA remains the largest — and in my opinion the best — state medical society in the country. We have tremendous momentum for reaching Dr. Speer’s goal of 50,000 members. Remember, it’s not just a number; every member increases our clout and ability to make a difference for all Texas physicians and your patients. Please do your part. Invite the good physicians you know to join. Today.

TMLT PUTS ANOTHER $30 MILLION IN TRUST REWARDS PROGRAM

The Texas Medical Liability Trust (TMLT) has dedicated $30 million more to the Trust Rewards Program for 2013. Funds are returned to physicians on retirement or other qualifying event. Trust Rewards is TMLT’s way of rewarding policyholders for their loyalty. This announcement brings the Trust Rewards total to $130 million. No other medical liability insurer offers this much to Texas physicians. TMLT is the only medical professional liability insurance provider created and exclusively endorsed by TMA.