Stories from Texas Medicine, June 2013

ACOs, Texas-Style - 04/24/2018

Burdensome federal regulations and antitrust rules and hefty overhead costs are oft-cited stumbling blocks to physician involvement in accountable care organizations (ACOs). So perhaps it came as little surprise when the Texas Legislature, less than enamored with the federal health reform legislation that authorized the coordinated care models, came up with its own rendition. In 2011, state lawmakers passed Senate Bill 7, which created a Texas-style ACO, known as a health care collaborative, to encourage physicians, hospitals, and payers to collaborate on more coordinated, cost-effective health care delivery. Now that the Texas Department of Insurance has adopted rules laying out a path to licensure as a collaborative, Texas physicians have a more flexible option that overcomes many of the barriers preventing them from stepping into integrated care models.

Investing in Prevention - 04/19/2018

The Patient Protection and Affordable Care Act requires most private health insurance plans and Medicare to cover certain U.S. Preventive Services Task Force (USPSTF) services without patients sharing costs. The services are in four categories: evidence-based screenings, counseling, routine immunizations, and preventive services for women and children. Some physicians may already perform those services for their patients but miss out on additional payment; others may not realize the range of preventive services that would benefit patients. Still others may be unsure of the fiscal sustainability of providing the services. To help physicians make those assessments, the Texas Medical Association Council on Health Care Quality has developed 36 interactive "prevention calculators" encompassing all of the billing codes associated with each USPSTF guideline.

Bad Air Day - 05/13/2016

In an unpredictable economy, policymakers look to alternative energy sources to fuel the future. And as scientific research exposes the link between air pollution and disease, physicians seek ways to restrict the amount of toxins patients breathe. A report released earlier this year examines retrofitting the Big Brown, Martin Lake, and Monticello coal-fired facilities in Northeast Texas with modern emission controls or replacing them with cleaner alternative energy sources. the report targets 1970s-era coal-fired plants because they are the leading emitters of air pollutants and greenhouse gases in Texas.

Payback Possible - 05/13/2016

Physicians are being chosen by the Centers for Medicare & Medicaid Services (CMS) for electronic health record (EHR) meaningful use audits. Any physician who has received a meaningful use incentive payment is fair game for an audit. CMS expects to audit about 5 percent of participants in the Medicare and Medicaid EHR incentive payment programs. Physicians who have attested to meaningful use or who plan to attest are urged to document the process carefully. They should maintain, for at least six years, documentation supporting the meaningful use measures, calculations, and data submitted during attestation.

Magic Number - 05/13/2016

The 2011 Accreditation Council for Graduate Medical Education rule restricting interns' work hours is one of the bigger changes among reforms intended to improve patient safety, residents' education, and their quality of life by reducing fatigue for physicians-in-training. Several recent studies suggest the rule may have missed the mark. Reported increases in patient handoffs and medical errors and less preparation of interns to take on more senior roles contribute to an overall perception that shift limits diminish the quality of residents' training and potentially patient care.

Digital Diagnosis - 05/13/2016

The emerging practice of telemedicine allows physicians to consult with patients over the telephone and through live Internet chats, a webcam, or other electronic means. However, it has its limits. Telemedicine may increase patients' access to care, but face-to-face examinations are still vital.