The TMA has developed tools to help practices determine if BTE participation makes financial sense and how to become eligible for the BTE program. The BTE program in Texas is currently available for Asthma, Cardiac Care, and Diabetes

 

BTE Return on Investment Tool: Estimate If BTE Participation Is Practical for Your Practice

The ROI calculator asks for inputs to estimate revenue and expenses to generate an estimate of potential incentive dollars available.

First, Determine the number of patients that the payer has attributed to your practice. Then estimate the costs associated with reporting on this BTE condition. The tool will calculate the costs and potential revenue that can be earned from BTE participation and/or NCQA participation (where applicable).

The BTE Return on Investment tool is available for Asthma, Cardiac Care, and Diabetes.

BTE Eligibility Tool: Determine Which Patients Will Meet BTE Eligibility Requirements

BTE eligibility varies slightly by condition, but generally requires 25 established patients who have been initially diagnosed and seen once or more prior to a 12 month period (with at least one visit within the last 12 months).

Enter patient information one at a time, including name (or Patient ID), birth date, relevant diagnosis, diagnosis date, and date of visit. Enter subsequent visits using the same form. As patient data is entered, the calculator will automatically determine patient eligibility. The most recent possible reporting period will be used. The tool will notify you when you have reached the required number of eligible patients.

The BTE Eligibility tool is available for Asthma, Cardiac Care, and Diabetes.

 

Practices should understand how well they deliver evidence-based care to their patient populations with these conditions.

Use this tool to evaluate the care your practice provides against evidence-based guidelines.

Download the flowchart 

Below are the measures that qualify in pay-for-performance and physician-rating programs for these clinical conditions in Texas.

 

These include public programs like Medicare as well as commercial insurance programs. These measures were developed from evidence-based guidelines.

Practices should understand how well they deliver evidence-based care to their patient populations with these conditions -- even if they aren’t seeking a bonus. Look to your special society for recently released or newly developed measures.

 

Asthma   Back Pain   Cardiovascular Prevention   Cataracts   Chronic Kidney Disease   Chronic Obstructive Pulmonary Disease   Coronary Artery Bypass Graft   Coronary Artery Disease   Dementia   Diabetes Heart Failure

Hepatitis C   HIV/AIDS   Hypertension Inflammatory Bowel Disease Ischemic Vascular Disease Oncology   Parkinson’s   Perioperative Care   Preventive Care   Rheumatoid Arthritis   Sleep Apnea

 

Texas physicians are ripe for education on the benefits of current quality-of-care programs, including the use of patient satisfaction surveys to assess performance and quality.

There are a variety of available training and continuing education programs available which address the need for Quality Improvement. TMA has compiled a list of available programs in Texas and nationwide.

Download the list of Quality Improvement programs

The TMA has developed the Emergency & Medication Record tool to assist patients in tracking and communicating their personal health status and medications.

 

The tool asks patients for information to generate a pre-formatted printable document which can be easily folded and carried at all times. This printed record is ideal for patients who do not otherwise carry this information with them by other means such as electronic devices. The tool should be reviewed on a regular basis to ensure accuracy.

Download the Personal Emergency & Medication Record tool 

The TMA has developed these well-received calculators that can serve as a response to the obstacles presented by the USPSTF preventive guidelines

These interactive, but simple calculators serve to educate physicians on the requirements and billing codes associated with each metric. Enter your data on patients seen and contracted rates for each identified code into the calculator. This allows you to see the benefits of providing such care, as well as to analyze the fiscal sustainability of providing this preventive service.
 

• General Prevention 

Adults

Abdominal Aortic Aneurysm, Screening   Alcohol Misuse Screening and Behavioral Counseling Interventions  Aspirin for the Prevention of Cardiovascular Disease  Asymptomatic Bacteriuria in Adults, Screening  Breast Cancer, Screening  Breastfeeding, Primary Care Interventions to Promote  Breast and Ovarian Cancer Susceptibility, Genetic Risk Assessment and BRCA Mutation Testing  Cervical Cancer, Screening  Chlamydial Infection, Screening  Colorectal Cancer, Screening  Depression, Screening  Type 2 Diabetes Mellitus in Adults, Screening   Folic Acid Supplementation

Gonorrhea, Screening  Hepatitis B Virus Infection, Screening   High Blood Pressure, Screening  HIV, Screening  Iron Deficiency Anemia, Screening  Lipid Disorders in Adults, Screening   Obesity, Screening   Osteoporosis, Screening  Rh (D) Incompatibility, Screening  Sexually Transmitted Infections, Counseling  Syphilis Infection, Screening  Tobacco Use and Tobacco-Caused Disease, Counseling and Interventions

Pediatrics

Major Depressive Disorder in Children and Adolescents, Screening  Hearing Loss in Newborns, Screening  HIV, Screening  Congenital Hypothyroidism, Screening  Iron Deficiency Anemia, Prevention

Obesity in Children and Adolescents, Screening   Phenylketonuria, Screening  Sickle Cell Disease, Screening  Sexually Transmitted Infections, Counseling  Visual Impairment in Children Younger than Age 5 Years, Screening

Please feel free to contact us with any questions.

 

Refer to these portions of the TMA website:

Deadlines for Doctors 
Continuing Medical Education
HIT
TMA Practice Consulting
Payment Advocacy
Physician Oncology Education Program  (POEP)  

Or Contact the TMA Knowledge Center:
(800) 880-7955
knowledge@texmed.org
Ask TMA 

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