120.010 Principles for Evaluating Health System Reform

120.010

Principles for Evaluating Health System Reform: The Texas Medical Association will use the following principles as evaluation criteria in examining all national health system reform proposals. These principles are not ranked in order of importance; all are viewed as high priorities.

  • Promote portable and continuous health care coverage for all Americans using an affordable mix of public and private payer systems.
  • Promote patient safety as a top priority for reform, recognizing an effective mix of initiatives that combine evidence-based accountability standards, committed financial resources, and rewards for performance that incentivize and ensure patient safety.
  • Adopt physician-developed, evidence-based tools for use in scientifically valid quality/patient safety initiatives that incentivize the physician-led health care delivery team, and include comparative effectiveness research used only to help those in patient-physician relationships choose the best care for patients.
  • Preserve patient and physician choice and the integrity of the patient-physician relationship.
  • Incorporate physician-developed, evidence-based measures and preventive health and wellness initiatives into any new or expanded health benefits package as a means to promote healthier citizens.
  • Recognize and support the role of safety-net and public health systems in delivering essential health care services within our communities, to include essential prevention and health promotion public health services.
  • Support the development of a well-funded, nationwide emergency and trauma care system that provides appropriate emergency and trauma care for all Americans.
  • Support public policy that fosters ethical and effective end-of-life care decisions, to include requiring all Medicare patients to have an advance directive that a Medicare enrollee can discuss as part of a covered Medicare visit with a physician.
  • Provide sustainable financing mechanisms that ensure the aforementioned affordable mix of services, and create personal responsibility among all stakeholders for financing and appropriate utilization of the system.
  • Invest needed resources to expand the physician-led workforce to meet the health care needs of a growing and increasingly diverse and aging population.
  • Provide financial and technological support to implement physician-led, patient-centered medical homes for all Americans, including increased funding and compensation for services provided by primary care physicians and the services provided by non-primary care, specialist physicians as part of the patient-centered medical home continuum.
  • Through public policy enactments, require accountability and transparency among health insurers to disclose how their premium dollars are spent, eliminate preexisting condition exclusions, simplify administrative processes, and observe fair and competitive market practices.
  • Reform the national tort system to prevent non-meritorious lawsuits, keeping Texas reforms in place as enacted by the Texas Legislature and constitutionally affirmed by Texas voters.
  • Initiate a true cost of practice methodology that provides for annual updates in the Medicare Fee Schedule as determined by a credible, practice expense-based, medical economic index.
  • Provide incentives that support the universal adoption of interoperable health information technology that supports physician workflow, increases practice efficiency, is safe for patients, and enhances quality of care.
  • Require payers to have a standard, transparent contract with physicians that cannot be sold or leased for any other payer purposes without the express, written consent of the contracted physician.
  • Support efforts to make health care financing and delivery decisionmaking more of a professionally advised function, with appropriate standard setting, payment policy, and delivery system decisions fashioned by physician-led deliberative bodies as authorized legislatively (SC-HSR Rep. 1-A-09; amended CSE Rep. 2-A-19).

Last Updated On

June 11, 2019