Related Stories

TPHC Statement: Contact Tracing is Effective Scientific Tool to Combat COVID-19 - 06/05/2020

Statement by Texas Public Health Coalition Chair Jason V. Terk, MD, in response to recent questions about the State of Texas’ COVID-19 contact tracing program.


The Power of Data: UTHealth Publishes Claims Statistics - 04/30/2020

After three years of work, the Center for Healthcare Data at McGovern Medical School at UTHealth is sharing part of its growing trove of numbers for data-driven discussions on many aspects of health care in Texas. The center doesn’t have all the answers. But its work under a federal certification from the Centers for Medicare & Medicaid Services (CMS) has resulted in valuable state and regional statistics that the center leaders believe provide food not only for thought, but also for policy.


TMA Calls Governor’s Plan “Prudent and Careful” - 04/27/2020

Statement by Texas Medical Association (TMA) President David C. Fleeger, MD, in response to Texas Gov. Greg Abbott’s announcement that Texas hospitals now need to reserve only 15% of their capacity for COVID-19 patients.


Seeking a Measure of Reason: TMA Joins Collaborative to Standardize Quality Metrics - 03/31/2020

TMA joins collaborative seeking to identify and standardize quality metrics.


Going Nowhere: APM Committee Resignations Cast Doubt on Payment Models' Future - 03/31/2020

Resignations from HHS advisory committee cast doubt on future of physician-created alternative payment models.


Submit 2019 QPP Data by March 31 to Avoid a 7% Medicare Payment Cut - 03/02/2020

The data submission period for Medicare’s 2019 Quality Payment Program (QPP) is under way and closes on March 31. If you haven’t started the process, now is the time to ensure your data for the Merit-Based Incentive Payment System (MIPS) is in order and submit it in time to make corrections by the deadline, if needed.


Supporting Fair APM Payments: AMA Backs Accounting for Social Determinants of Health - 01/02/2020

Alternative payment models (APMs) are considered a key part of the future of value-based care. But for them to be successful, the American Medical Association says, APMs need to be fair, which means adjusting for the circumstances that make physicians’ cost and care challenges unique.


Out of Physicians' Hands: TMA Challenges Unfair Quality Measures on Medication Adherence - 12/04/2019

Only patients can pick up their own prescriptions, and only patients can propel that medication into their own bodies. Physicians can educate, emphasize, and admonish – but at the end of the day, they can’t restrain and “pill” a squirming, uncooperative patient like a dog or cat. It’s up to patients to do the right thing for themselves. Yet, some health plans’ quality programs are putting that onus on physicians – through medication adherence metrics that determine whether physicians and accountable care organizations (ACOs) in value-based contracts receive bonus payments.


Don't Miss Out! Medicare Pays for Chronic Care Management - 11/22/2019

Do you manage patient referrals and care transitions between and among physicians and health care settings? Do you spend time reconciling medication lists and managing prescription refills for your patients? Do you take calls during and after office hours to address patient care needs? If the answer is yes and you're not billing for these types of services, you're missing out on a new CPT code and practice revenue opportunity from Medicare.


More Pain for Small Shops? 2020 Quality Program Rule Could Mean More Penalties - 10/01/2019

Small and solo practices already take the worst of the administrative and financial pounding the Quality Payment Program (QPP) dishes out each year. In the Texas Medical Association’s analysis, the government’s plans for the QPP in 2020 would make the situation even harder on those smaller shops. Since QPP’s birth in 2017, small practices have struggled with the demands and synapse-straining complexities of the program’s Merit-Based Incentive Payment System (MIPS). And TMA analysis shows the payment penalties those “have-not” practices incur fund the bonus payments earned by MIPS “haves” – often, larger practices with the resources to make the program work. Under the 2020 changes that the Centers for Medicare & Medicaid Services (CMS) has proposed, the maximum penalties for practices who don’t hit their MIPS targets will be larger than ever. But TMA’s review shows that MIPS – despite CMS’ claims to the contrary – isn’t getting any simpler.


File Your MIPS Targeted Review Request by Sept. 30 - 09/18/2019

Physicians have two weeks to file a targeted review request to appeal errors in their 2018 Merit-Based Incentive Payment System (MIPS) performance feedback and 2020 Medicare payment adjustment under the Quality Payment Program (QPP).


Anybody There? Physicians Unfairly Penalized for AWOL Medicare Advantage Patients - 09/04/2019

You’ve tried and tried and tried. Phone calls, emails – nothing. A Medicare Advantage plan assigned you a patient who didn’t choose you, and the patient is driving that point home – by ignoring you. Or maybe the contact information the plan gave you is out of date, and the patient’s latest phone number or email is unknown. Either way, your as-yet-unseen patient is AWOL – and you can be penalized for it on health plans’ quality ratings, which ultimately can affect payments. New Texas Medical Association policy takes aim at the unfairness this lack of patient response can present for physicians, while opening up an opportunity for medicine to work with health plans to solve the problem.


Texas Physicians Push to Improve Health Care for LGBTQ Patients - 09/03/2019

Lesbian, gay, bisexual, transgender, or queer/questioning (LGBTQ) patients face unique barriers that put them at greater risk for mental and physical health problems. Often, their health disparities result from a lack of family support, public prejudice, and fear of the health care system. Texas physicians have launched a new workgroup and are adapting their practices to treat this underserved population.


Quality Care Pilot Takes Flight - 09/03/2019

How one children's clinic uses a targeted program to dramatically improve care, lower costs.


Physician, Hospital Groups Distribute Urgent Measles Advisory - 08/06/2019

Texas doctors and hospitals have a new tool to fight the ever-increasing measles threat, as the number of people sickened by the infectious yet preventable disease climbs. The Texas Medical Association (TMA) and Texas Hospital Association (THA) have created a new resource to help physicians, hospitals, and other health care professionals combat the highly contagious, yet entirely preventable, respiratory illness.


Unfair Playing Field? QPP Scoring May Hurt Physicians Not Hospital-Affiliated - 08/02/2019

As 2019 rolls on and physicians operate under new portions of the Merit-Based Incentive Payment System (MIPS), many physicians may face an even bigger disadvantage — simply by virtue of not billing the vast majority of their services at a hospital.


Physicians Concerned Over State’s Inaccurate Death Reporting - 06/25/2019

Some Texas physicians are concerned that the state’s death statistics are not as accurate as they should be. Like in many states, Texas’ death reporting system feeds inconsistent information into the state’s vital statistics database. As a result, distorted death statistics inaccurately portray how people are dying, which could have negative public health implications.


Faulty Guidelines - 06/03/2019

Former Texas Medical Association President Josie Williams, MD, was tenacious in advocating that organized medicine pay zealous attention to two topics: data and guidelines. In this, she was both sage and prescient. We have done well in following her recommendations on data, but we continue to fall far short of where we need to be on guidelines.


Get Awarded For Your Quality Work in 2018 - 05/23/2019

Did you submit Merit-Based Incentive Payment System data for the 2018 Quality Payment Program and feel like you deserve some kind of recognition for your hard work all year long? Apply now for the 2018-19 Physician Practice Quality Improvement Award.


Medicine to CMS: Medicare Report Inflates Success of Quality Program - 05/01/2019

If you read the recent Centers for Medicare & Medicaid Services (CMS) report on the first-year of the Quality Payment Program, you’d likely come away with the perception that the program’s launch was an overwhelming success. But a closer look by the Texas Medical Association raises serious doubts about CMS’ numbers, transparency, and cheerleading – so much so that TMA and seven other state medical associations are asking the agency to take back the report.


The Results Are In: Physicians Finally See How They Fared in First Year of MIPS - 10/16/2018

Physicians finally see how they fared in the first year of Medicare's "MIPS" quality payment program.


Learn From the Experts - 09/26/2018

The Texas Quality Summit, scheduled for November 18-19 and hosted by the Texas Medical Association and the American College of Medical Quality, will give physicians the tools they need to prosper in a value-based care environment.


Revved-up Reporting - 05/03/2018

As federal quality reporting mandates and noncompliance penalties add up, experts say registries can help take the sting out of the process and rev up quality improvement for physician practices. The online reporting tool is also taking a front seat over claims-based reporting as Medicare signals its plans to eventually phase out that less efficient and less clinically accurate option.


New TMF Network Aims to Improve Adult Immunization Rates - 04/25/2018

Despite the availability of effective vaccines to help prevent influenza, pneumonia, and shingles, immunization rates for adults remain significantly low. To help boost these numbers for Medicare beneficiaries, the TMF Quality Innovation Network Quality Improvement Organization has established the Immunizations Network for physicians and other health care professionals.


Register Now for the Texas Quality Summit - 04/24/2018

This fall, TMA is hosting a unique event to help you improve performance, increase efficiency, and continue to deliver high-quality care. Join your colleagues for the Texas Quality Summit Nov. 18–19, and get the latest resources and hands-on training to take your practice to the next level. Register now, as seating is limited.