By Phil West
Magazine story
The shift to Medicare Advantage for patients is remaking the physician payer mix, the terms on which physicians get paid, and – through prior authorization and narrow networks – growing risk-adjustment and documentation demands.
News
Gov. Greg Abbott’s office announced $87 million in new awards Oct. 29 – covering infrastructure, physician recruitment, and chronic-disease support. If your practice received a grant, TMA wants to hear from you. Contact us.
Texas physicians remain cautiously optimistic on new prior authorization federal requirements are taking effect, voluntary reforms by health plans they say will further reduce administrative burden, and Texas' gold card system.
From AI-driven downcoding to narrower networks, stalled No Surprises Act payments, Medicare Advantage's reshaping of the payer mix, and gold-card promises that haven't delivered, this issue traces how insurers are squeezing Texas physicians – and where TMA is pushing back.
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