Stories from Texas Medicine, August 2020

Road to Recovery: COVID-19 Tests, Bends, and Breaks Texas Practices - 08/03/2020

Ricardo Garza, MD, was still walking the tightrope: standing, but unable to withstand another gust of wind. COVID-19 swept away about 35% of the San Antonio solo cardiologist’s practice revenue, and that was just what he could calculate as he waited for insurers to process straggling claims. But he had returned to in-office operations without any layoffs. While some practices are surviving – and trying their best to prepare for future threats – others weren’t so lucky. On-the-ground experiences align with the Texas Medical Association’s Practice Viability Survey in showing COVID-19 was, and still is, a disruptor unlike any other – challenging or torpedoing the viability of various practice types.


Surge Response: How the Panhandle Handled One of the State’s Biggest COVID-19 Outbreaks - 08/03/2020

IN TEXAS, COVID-19 outbreaks have been especially pronounced in three types of facilities: nursing homes, jails or prisons, and meatpacking plants. The Amarillo area has plenty of all three. But it was the meatpacking plants that drew national attention to Amarillo’s COVID-19 problems. The city, which straddles Potter and Randall counties, has numerous plants that employ 12,000 to 15,000 people. In early April, Amarillo’s two hospitals began filling up with COVID-19 patients who worked at a plant in neighboring Moore County. Two weeks later, workers from a plant in Potter County flooded in.  


Quarantine’s Quandary: Some Texans Unable to Self-Isolate - 08/03/2020

As the state ramps up “contact tracing” as a key part of Gov. Greg Abbott’s plan to stop the spread of COVID-19 and return Texas to economic normalcy, some health officials say physicians can help those for whom quarantine and isolation are a challenge.


Leadership by Fire: Stephanie Stephens New Texas Medicaid, CHIP Director - 08/03/2020

Stephanie Stephens received a not-so-welcome gift entering her new job running Medicaid operations for the nation’s second-largest state: A global pandemic. In that sense, the universe wasn’t easy on Ms. Stephens, the new director of Medicaid and CHIP for the Texas Health and Human Services Commission (HHSC).


Pandemic Poses Legal Pitfalls: TMA Seeks Better Liability Shields - 08/03/2020

Under Texas law, physicians treating COVID-19 patients in a volunteer capacity have potential defenses against lawsuits that might arise from that care. But for non-volunteer physicians on the COVID battlefield – often working in harrowing, overloaded settings, high on patient count and low on equipment – the same liability shields don’t exist. And with a resurgence in COVID-19 cases and hospitalizations taking hold in June, the Texas Medical Association continued its pandemic-long push to extend liability protections to all frontline physicians, volunteer or not.


E&M Coding About to Change - 08/03/2020

First, the bad news: Physicians need to take some serious time between now and Jan 1, 2021, to study changes that are coming to Medicare outpatient evaluation and management (E&M) codes – changes most private insurers likely will follow. Now the good news: The changes should reduce the amount of documentation needed with each patient.


Talk to Patients About: What Is ImmTrac2? - 08/03/2020

ImmTrac2, Texas’ revised immunization registry, is designed to help people keep their vaccine records in order. Texas residents who sign up can have their immunization records stored for free, allowing physicians, schools, and other authorized people to see which shots a person has received and which ones they’ve missed.


Hearing Health Care Belongs to Primary Care - 08/03/2020

Like many areas of health care, hearing loss is best managed when hearing professionals collaborate closely with physicians. Primary care physicians (PCPs) are uniquely suited to manage hearing loss because 1) patients trust their PCP; 2) PCPs have insight into the overall health and well-being of their patients; and 3) the PCP workforce is large enough to make a meaningful impact. Accountable care organizations, clinically integrated networks, and patient-centered medical homes are perfectly suited to be a positive force in the hearing health of their patients.