TMA Launches Physician Services Organization for Patient Care
Texas' premier physician associations have established an organization to deliver doctors the survival tools they need to provide demonstrably better and more efficient patient care and compete in today's health care marketplace.
"I am confident the Physician Services Organization for Patient Care will save local practices," said Texas Medical Association President Stephen L. Brotherton, MD. "Texas doctors are determined to make health care better and more affordable for Texans. To do that, we need to shift the balance of power away from the government and the large hospital systems, and back to the patients and their physicians."
Besides TMA, the Dallas County Medical Society (DCMS) and the Harris County Medical Society (HCMS) are key members of the organization. It will bring in new and existing physician groups, health plans, and technology vendors as needed to test and develop effective new care models.
The Physician Services Organization for Patient Care will offer services that bolster physicians' clinical and financial autonomy, tailored to a practice's current level of sophistication. A key element will be giving physicians easy access to data to measure and improve their clinical performance and financial viability.
"The health care landscape is changing dramatically for solo physicians to large group practices," said DCMS President Cynthia Sherry, MD. "This new organization will help all types of physicians deal with this great change. DCMS is proud to partner with TMA to provide these essential tools to physicians. Together we will help physicians meet quality benchmarks for patient care, leverage information technology, and compete successfully in changing financial models. The real winners will be patients."
HCMS President Russell W.H. Kridel, MD, said the new organization "will provide services to help physicians navigate the changing health care delivery system. The best use of a physician's time is in directly taking care of the patient one on one, not in dealing with red tape, reporting measures, and compliance regulations. This is exactly what is needed to maintain the sacred patient-physician relationship. It's very exciting to see new innovative projects like this that can help physicians spend more time with their patients."
"This is a physician-driven enterprise to improve patient care," said TMA Board of Trustees member Dan McCoy, MD, who chaired the task force that developed the project plan. He said it will "use the latest technology and data-analytics tools to bolster the bedrock of our profession: the patient-physician relationship."
For example, one service might help physicians comb through their data to identify chronically ill patients who need extra help to stay as healthy as possible and stay out of the hospital. Another might align primary care physicians and specialists to better coordinate the care they provide to their common patients.
"The market is shifting rapidly. Physicians are under tremendous pressure to change what they've been doing. But no one is helping them do that," Dr. Brotherton said. "This is a very high priority."
Added TMA trustee Don Read, MD, of Dallas, "This is the most important thing TMA has done since tort reform."
Specific pilot projects in various geographic areas of the state will be announced in coming weeks.
For more information, email Kim Harmon, director of special projects for TMA.
Appeals Court Backs TMA on Workplace Breastfeeding
The Fifth Circuit U.S. Court of Appeals agrees with TMA and the Texas Pediatric Society (TPS) that a Houston federal judge wrongfully ruled against a woman who says her employer fired her because she wanted to pump breast milk. The court said "discriminating against a woman who is lactating or expressing breast milk" violates federal law. It overturned the decision and sent the case back to the trial court for further proceedings.
TMA and TPS said in a brief to the appeals court that U.S. District Judge Lynn Hughes erred when he ruled that childbirth ends pregnancy-related medical conditions and that Title VII of federal law does not protect women from being discriminated against or fired for lactation and breast pumping.
TMA and TPS filed the brief to support an appeal by the U.S. Equal Employment Opportunity Commission (EEOC) of Judge Hughes' decision in favor of a Houston debt collection agency against the woman, Donnicia Venters. EEOC charged that Houston Funding II Ltd. fired Ms. Venters after she sought approval to pump breast milk at the office. Judge Hughes ruled that even if that were true, Ms. Venters could not claim discrimination under Title VII because lactation is not pregnancy, childbirth, or a related medical condition.
TMA and TPS argue in their brief that federal law protects lactation because it is one of several medical conditions related to pregnancy that require care after childbirth. "Since the yielding of milk by mammary glands is a medical condition caused by pregnancy and childbirth, lactation is a 'related medical condition' as contemplated by Title VII," the brief said.
"Title VII protects employees from being fired 'because of sex' or 'on the basis' of sex," it added. "Congress amended Title VII, in response to a Supreme Court case, to clarify that those terms 'include, but are not limited to, because of or on the basis of pregnancy, childbirth, or related medical conditions.' It is clear that Congress intends to protect women, such as Venters, from being fired based on medical conditions relating to their pregnancy and/or childbirth."
The brief also says breastfeeding benefits both the mother and child and that public policy demands protection for lactating mothers at work. Thus, TMA and TPS said, a jury should decide whether Houston Funding discriminated against Ms. Venters, or, as the company claims, it fired her for abandoning her job.
E-Prescribe by June 30 to Avoid 2014 Penalties
To avoid penalties in 2014 (2 percent of Medicare Part B claims), Medicare physicians must report e-prescribing using G-code G8553 via claims on at least 10 unique Medicare encounters by June 30.
To qualify for the 2013 incentive (0.5 percent of Medicare Part B claims) and prevent the penalty in 2015, physicians must report at least 25 unique e-prescribing Medicare encounters during 2013. Follow the instructions in TMA's 2013 e-prescribing informational paper.
Escalating Medicare penalties for failing to e-prescribe began in 2012:
| |
|
2012
|
2013
|
2014
|
Beyond
|
Incentive
|
|
1%
|
0.5%
|
None
|
None
|
Penalty
|
|
1%
|
1.5%
|
2%
|
2%
|
If you plan to apply for the Medicare electronic health record (EHR) incentive in 2013, note that you can't receive the e-prescribing incentive in the same payment year. Physicians applying for the Medicaid EHR incentive are still eligible for e-prescribing incentive payments.
Find out more, including information about exemptions, on the TMA 2013 E-Rx Penalty and Incentive Guidelines page. If you need help with e-prescribing, turn to the Texas regional extension centers (RECs). RECs provide support to help with e-prescribing, EHR selection, workflow analysis, staff training, EHR incentives, and much more. Visit TMA's Texas REC Resource Center for more information.
For questions about e-prescribing or other health information technology (HIT) issues, contact TMA's HIT Department by telephone at (800) 880-5720 or by email, or visit the TMA EHR Incentive Program Resource Center.
|