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 Volume 18, No. 19                  

May 23, 2016            


MACRA: Good, Bad, or Downright Ugly for Physicians?

We cheered when Congress repealed Medicare’s Sustainable Growth Rate (SGR) formula last year. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) not only removed the constant threat of Medicare payment cuts, but also promised to simplify the ever-tightening thicket of federal regulations that strangle physicians’ practices. The Centers for Medicare & Medicaid Services’ (CMS’) plans to implement the new law, however, leave me less than enthusiastic. We’re studying the 426 pages of proposed MACRA regulations carefully. I sent TMA chief lobbyist Darren Whitehurst and Angie Ybarra, our director of clinical advocacy, to Washington for in-depth discussions with the American Medical Association and national specialty societies. We listened carefully to the first of two MACRA briefing sessions that AMA set up with CMS officials. Here are my topline observations so far: 

  • MACRA is far more complex, confusing, and controlling than the Physician Quality Reporting System, meaningful use, and value-based modifier programs it is replacing.
  • Compliance will be especially difficult for small practices who may end up with Medicare payment penalties even if they spend the time and money to jump through all the new regulatory hoops.
  • The system of bonuses and penalties pits physician practices against each other, so that there will be winners and losers regardless of how well all practices “perform” on these new quality standards. 

We are asking for physician feedback (email us at macra@texmed.org) as we develop detailed official comments on the draft regulations. In the meantime, I urge physicians from practices of all sizes to visit TMA’s MACRA Resource Center to learn about the new law and proposed regulations.

Tomorrow Is Election Day; Please Vote

Party primary runoff elections take place across Texas tomorrow. Based on local physician recommendations, TEXPAC endorsed 10 state Senate and House candidates. Please vote for: 

  • Senate District 1: Rep. Bryan Hughes (R)
  • Senate District 24: Dawn Buckingham, MD (R), or Rep. Susan King (R)
  • House District 18: Ernest Bailes (R)
  • House District 27: Rep. Ron Reynolds (D)
  • House District 33: Justin Holland (R)
  • House District 54: Scott Cosper (R)
  • House District 64: Lynn Stucky (R)
  • House District 73: Rep. Doug Miller (R)
  • House District 128: Rep. Wayne Smith (R) 

More Help Needed for Zika Screening, TMA Member Tells Senate Committee

Texas needs to find more ways to screen pregnant women for the Zika virus, a Houston obstetrician whose high-risk pregnancy clinic has been overrun by women concerned about Zika infection told the Senate Health and Human Services Committee. Catherine Eppes, MD, from the Baylor College of Medicine, a member of the TMA Committee on Maternal and Perinatal Health, was among several Zika experts the committee invited to testify. “The combination of a relatively new but profoundly significant disease with little knowledge about the exact timing and rates of transmission, and complex, often inaccessible testing options leaves pregnant women and physicians frustrated,” she said. “I think doctors would benefit from statewide dissemination of the options and costs for testing within our state and city health departments.” Dr. Eppes also recommended that both Texas Medicaid and the Women’s Health Program be authorized to support the screening and testing of their eligible populations.

El Paso Medical Student Named to Texas Tech Board of Regents

A student at the Texas Tech University Health Sciences Center-El Paso was one of 10 people Gov. Greg Abbott appointed as student regents to the boards that govern the state’s institutions of higher education. Congratulations to Jeremy Stewart, an active leader in the TMA Medical Student Section, for his one-year appointment to the Texas Tech University System Board of Regents.

TMA Asks State Mega-Agency to Request More Medicaid, Public Health Funding

It’s that time in the state’s two-year budget cycle when state agencies prepare funding requests for the Texas Legislature to consider in next year’s session. No agency’s budget is more important to physicians than that of the Health and Human Services Commission (HHSC), whose massive portfolio includes the state’s Medicaid, public health, mental health, and women’s health programs. In an official letter to HHSC leadership, TMA and state specialty societies representing family physicians, pediatricians, and OB-gyns laid out physicians’ funding priorities for the 2018-19 state budget. Competitive physician payments in Medicaid and reversal of the steep funding cuts for dual-eligible patients topped our list of recommendations. We also called for better funding for: women’s preventive, primary, and behavioral health care; mental health and substance abuse services; local and state infectious disease surveillance; vaccination and antitobacco programs; and early childhood programs for children with developmental or physical disabilities.

Brand New: The Texas Physician’s Accountable Care Guide

Looking to join or start an accountable care organization (ACO)? Check out the newest publication in the TMA Education Center. The Texas Physician’s Accountable Care Guide is a concise manual, emphasizing the importance of physician leadership in these new health care delivery models. Special thanks to The Physicians Foundation, TMA PracticeEdge, the North Carolina Medical Society, and the Smith Anderson law firm for their support.