Stories from Texas Medicine, September 2015

Shooting for Safety - 04/25/2018

Austin Regional Clinic announced in June that it would no longer accept new pediatric patients whose parents or guardians don't permit vaccinations. The new policy aims to protect the clinic's most vulnerable patients, such as infants who aren't fully vaccinated, seniors, those who have compromised immune systems, and pregnant women. An exception is included for patients who have adverse reactions to vaccines or severely compromised immune systems.


SGR Is Gone. Now What? - 04/17/2018

Physicians will have to prepare to participate in one of the new payment systems that will replace Medicare's Sustainable Growth Rate formula, which Congress eliminated in April via the Medicare and CHIP Reauthorization Act. Come 2019, physicians can participate in one of two major payment tracks: the fee-for-service Merit-Based Incentive Payment System, which boosts or docks physician pay based on their quality and cost performance; or one or more alternative payment models, such as accountable care organizations, medical homes, bundled payments, or other initiatives.


Regs and Pains - 05/25/2016

Newly adopted changes to the Texas Medical Board's pain management rules turn numerous chronic pain treatment guidelines into minimum requirements. The stricter rules prompt liability concerns as the board strives to ensure patients receive treatment that matches the evolving standard of care.


Medicare Pays for Chronic Care Management - 05/13/2016

As of January, the Centers for Medicare & Medicaid Services began paying for chronic care management of patients with two or more conditions under its Chronic Care Management program. The payment applies to patients in traditional fee-for-service and noncapitated Medicare Advantage plan arrangements. Texas Medical Association leaders caution the program has some hefty requirements.


Farewell to 40 Years of Service - 05/13/2016

The impending implementation of the ICD-10 coding system and burdensome regulations spur Austin Internal Medicine Associates to close its doors on Sept. 4, ending 40 years of service and more than 20 years together for its internists — Ace Alsup, MD; Isabel Hoverman, MD; R. Scott Ream, MD; and Frank Robinson, MD. The group set its closing date to avoid anticipated technical difficulties — specifically, the Centers for Medicare and Medicaid Services' requirement that all practices switch to the controversial ICD-10 medical billing and coding system on Oct. 1.


Better Bridges, Better Systems - 05/13/2016

An electronic health record (EHR) research project illustrates the need for physicians to get involved in usability testing to help vendors improve their products. Some of the research centered on testing EHR systems for usability and interviewing EHR vendors about their capabilities to build systems tailored to the needs of the user. The usability testing of commercial EHRs largely confirmed what many physicians report from their own experience: EHR systems are often difficult to use and hinder patient care in a clinical setting.