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Closing the Loop: Payers Address Social Drivers of Health - 03/15/2024

Houston family physician Lindsay Botsford, MD, received a call in late February from a Medicare patient with shingles. She prescribed an antiviral medication to treat the infection – and then the real work began.

Healthy Life Requires More Than Just Good Health Care, Survey Says - 08/31/2023

People need good health care, but 57% of Texans know that isn’t everything when it comes to being healthy. Instead, factors like where people live, work, and relax have a bigger impact, most Texans told a recent survey.

ACOs, Texas-Style - 07/17/2023

Burdensome federal regulations and antitrust rules and hefty overhead costs are oft-cited stumbling blocks to physician involvement in accountable care organizations (ACOs). So perhaps it came as little surprise when the Texas Legislature, less than enamored with the federal health reform legislation that authorized the coordinated care models, came up with its own rendition. In 2011, state lawmakers passed Senate Bill 7, which created a Texas-style ACO, known as a health care collaborative, to encourage physicians, hospitals, and payers to collaborate on more coordinated, cost-effective health care delivery. Now that the Texas Department of Insurance has adopted rules laying out a path to licensure as a collaborative, Texas physicians have a more flexible option that overcomes many of the barriers preventing them from stepping into integrated care models.

Mastering Quality Reporting: Ease the Challenge of Quality Reporting - 07/10/2023

Understanding the maze of quality reporting pathways may help ease the challenge.

Community Connections: TMA’s Council on Health Promotion Helps Physicians Boost Hometown Health - 04/03/2023

The Texas Medical Association's Council on Health Promotion oversees the organization's outreach programs and helps develop new ones. These programs are used by county medical societies, alliance chapters, medical student groups, and medical practices to improve community health.

Healthy Determination: Texas Physicians are Finding Better Ways to Address Their Patients’ Social Determinants of Health - 03/27/2023

Austin pediatrician Sandra Frasser, MD, learned early in her medical career that many of the biggest health problems patients face cannot be fixed by a trip to the doctor’s office.

Medicare Bundled-Payment Model Could Expand Access to Value-Based Specialty Care - 01/26/2023

Medicare’s recent extension of a bundled payment model marks a rare opportunity for more specialists to participate in value-based care and could pave the way for better coordination with primary care.

New TMA Task Force on Alternative Payment Models Charts a Path Toward Value-Based Care - 01/26/2023

The shift from fee-for-service to value-based care is underway, with public and private payers introducing myriad new payment models in recent years. But many physicians find the variety of plans overwhelming, and the investments necessary to support them challenging.

Medicare Fee Schedule a Mixed Bag for 2023 - 01/26/2023

The Centers for Medicare & Medicaid Services (CMS) recently posted the 2023 Medicare Physician Fee Schedule, which takes effect Jan. 1 and brings with it a mixed bag of consequences for physicians.

Holding Their Own: Texas ACOs Contribute to Billions in Savings in Medicare Program - 11/01/2022

For the fifth straight year, the Medicare Shared Savings Program (MSSP), through its work with accountable care organizations (ACOs), generated significant savings and high-quality results, with Texas entities once again contributing to that success.

What's New in Value-Based Care - 09/23/2022

Once dubbed unicorns, value-based care (VBC) models that eschew fee-for-service payment in favor of rewarding quality have materialized; the Texas Medical Association aims to be on the crest of this wave with the formation of its new Task Force on Alternative Payment Models.

Texas ACOs Contribute to $1.6 Billion in Savings in Medicare Shared Savings Program - 09/09/2022

For the fifth straight year, the Medicare Shared Savings Program (MSSP), through its work with accountable care organizations, generated significant savings and high-quality results, with Texas entities once again contributing to that success.

Medicare ACOs Face Key Changes in Proposed Fee Schedule - 08/10/2022

In an effort to boost participation in accountable care organizations, Medicare has significant changes to its shared savings program on tap in the proposed 2023 physician fee schedule.

Making a Comeback: Texas Leads the Nation in Congenital Syphilis - 07/29/2022

Texas leads the nation in congenital syphilis cases, and physicians are key to bringing both syphilis and congenital syphilis under control again.

Value-Based Care for All: Practices of All Sizes Can Make the Switch - 07/29/2022

Moving away from fee-for-service requires taking on risk as well as hiring staff, launching new programs, and investing in data analysis, but practices of all stripes have made the switch successfully.

How to Start a Medical-Legal Partnership - 06/29/2022

Medical entities can join forces with legal entities to form medical-legal partnerships (MLPs), and these partnerships are helpful for patients whose conditions are worsened by social determinants of health.

The Power of Data: UTHealth Publishes Claims Statistics - 06/29/2022

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.

Survey: Addressing Patients’ Social Determinants of Health Fuels Physician Burnout - 04/01/2022

Physicians have long known how social determinants, or drivers, of health impact their patients’ lives, fuel disparities, increase care costs, and ultimately influence physicians’ quality outcomes and payment. They also have a sizable impact on physicians’ mental health, according to part one of The Physicians Foundation’s 2022 Survey of America’s Physicians.  

Navigating a Broken System: Helping Patients Use Health Resources - 03/31/2022

Whether patients do or don’t have health insurance, they need physicians’ help to make the most of their health care resources.

TMA Supports New Quality Measures for Social Determinant Screening - 03/10/2022

Showing its continued commitment to highlighting and addressing social determinants of health, the Texas Medical Association offered its “strongest support” to a pair of new quality measures the National Quality Forum (NQF) is considering for screening of those social factors.

Creative Collaboration: Here’s How Physician Practices Can Help Patients Address Their Social Determinants of Health - 09/06/2021

For physicians, addressing social determinants of health can be difficult because they are set in motion long before a patient arrives for a visit and can undermine the best of medications and treatments.

Health Disparity Report: Texas’ Black Infant Mortality Drops; Other Numbers Mixed - 07/14/2021

While the U.S. has made some improvements in health during recent years, deep and widespread health disparities persist – and, in some instances, have grown, according to the America’s Health Rankings 2021 Health Disparities Report, which also contains some Texas-specific data.

House Approves Bill to Help Address Social Determinants of Health - 05/06/2021

The Texas House of Representatives signed off on establishing a state office for health equity Wednesday morning, agreeing with medicine on the need for a new mechanism to address social determinants of health.

Hungering for a Solution: Physicians Can Help Tackle Food Insecurity - 02/01/2021

Not long after COVID-19 hit Texas last March, pediatricians at Austin Regional Clinic (ARC) began screening patients for food insecurity. The timing was coincidental but fortunate given the pandemic’s economic toll.

Rewarding Results: Texas Medicare ACOs Perform Promisingly - 11/30/2020

For the Medicare Shared Savings Program (MSSP) and many of the accountable care organizations (ACOs) that participated in it, 2019 was billed as a transition year. But data released by the Centers for Medicare & Medicaid Services (CMS) in September show Texas ACOs fared quite well last year – and a number of Texas physicians and ACO officials say the savings generated are worth the gruntwork that MSSP requires.