Physicians from counties near and along the Texas-Mexico border gathered virtually Tuesday to explore ways to protect patients from COVID-19, which continues to spread rapidly throughout the region.
During a Texas Medical Association/Border Health Caucus telephone town hall that specifically focused on health care needs along the border, 38% of physicians said they were concerned about rising COVID-19 cases and hospitalizations.
Those same physicians also would like stronger public messages calling for social distancing, masking, and other community mitigation efforts.
As of Tuesday afternoon, several border counties had more than 1,500 COVID-19 cases, including El Paso County, which had more than 4,500 cases, according to data from the Texas Department of State Health Services (DSHS).
Caucus Chair Luis Urrea II, MD, of El Paso, and TMA President-Elect E. Linda Villarreal, MD, of Edinburg (pictured), hosted and moderated the event.
The pandemic’s economic fallout makes preserving funding for Medicaid and the Children’s Health Insurance Program (CHIP) absolutely vital, especially in border counties, TMA Past President Douglas W. Curran, MD, told the town hall. The border region is home to an estimated 25% of enrollees in Texas Medicaid and CHIP, programs that are vital for addressing health inequities that border physicians see frequently, he said.
“We’re going to start seeing a huge percentage of the population begin to move into [Medicaid] because they’re going to lose their health insurance and they’re going to lose their jobs,” Dr. Curran said. “They’re not going to have the resources or the income to manage any of this.”
Medicaid and other health programs tend to face steep budget cuts at the state level during economic hard times because they make up about one-third of the Texas budget, Eva DeLuna Castro, a budget expert with Every Texan, formerly the Center for Public Policy Priorities, told participants.
“Like that old saying goes about the bank robber, that’s where the money is,” she said.
Also, Texas traditionally does not fund health care well, Ms. DeLuna said.
“I’ve been analyzing the state budget for 30 years, and [Texas has] always ranked in the bottom five among states in how much we invest in our public services,” she said.
Physicians should prepare immediately for the next state legislative session, which starts in January, by speaking with Texas lawmakers about the importance of preserving Medicaid and CHIP, Dr. Curran said.
“We’ve got to prepare our legislators now,” he said. “If you don’t know who your legislator is, if you don’t have a relationship with him where you can call and pick up the phone and get a cup of coffee, get one. It’s time to move out there, it’s time to build relationships, it’s time to get them in the game.”
Town hall participants also were asked how their Medicaid participation would be affected if Texas lawmakers cut Medicaid physicians payments by 2.5% to 5%, a possibility in the next session of the legislature.
- 24% said they would continue to accept all new Medicaid patients;
- 25% said they would accept new patients with limits;
- 25% said they would stop accepting all new Medicaid patients but would continue seeing existing patients;
- 21% would discontinue participating in Medicaid; and
- 5% would close their practices.
The town hall fielded questions from physicians, like Melinda Fierros, MD, a San Antonio psychiatrist, who asked if gains in telemedicine made at the start of the pandemic can be preserved.
Many of the payment and regulatory obstacles to telemedicine were taken down temporarily starting in March when telemedicine suddenly became vital for safely treating patients, said Ogechika Alozie, MD, an El Paso infectious disease specialist and a member of the TMA COVID-19 Task Force. But those gains – such as payment parity with in-person visits – could be reversed if physicians are not vigilant, he said.
“TMA will continue to strongly advocate that we need payment parity, not just for COVID-19, but changing telemedicine to medicine,” he said. “I think that’s the future of health care going forward.”
About two-thirds of the town hall participants said 50% or more of their patients are able to connect to a telemedicine visit without any technical support.
Tuesday’s telephone town hall was the first of a series of virtual events the Border Health Caucus and border-area county medical societies have planned for this summer as a replacement for the group’s annual Border Health Conference. Learn more on the Border Health Caucus webpage.