Contents tagged with payment

  • Without investing in physician training, health care bill creates aims without the means

    Tags: budget, family medicine residency program, health care reform, medical home, legislature, family physician, payment

    Wednesday, June 1, 2011 4:15:00 AM
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    An important piece of legislation designed to improve quality and lower costs in our fractured and inefficient health care system has received a second chance in the Special Session after dying in the House when time ran out on the 82nd Texas Legislature. However, because of other actions taken by our legislators that defund primary care residency training and other programs to bolster the physician workforce now and in the future, Senate Bill 8’s laudable goals are left without the means to achieve them.

    The overarching goal of S.B. 8 is to reverse the negative trend in our health care system, to bend the cost curve by testing and implementing various performance-based payment methods that provide incentives for improved patient outcomes. It achieves this through two key mechanisms: the creation of health care collaboratives and the creation of the Texas Institute of Health Care Quality and Efficiency.

    As envisioned in the bill, health care collaboratives clinically integrate physicians, hospitals, diagnostic labs, imaging centers, and other health care providers, aligning financial incentives to keep patients healthy and out of the hospital and emergency room. They are designed to move the delivery system away from a fee-for-service based system—where physicians and hospitals are paid for quantity of services over quality—to one in which doctors, hospitals, and other providers are accountable for the overall care of the patient and the total cost of the care provided.

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  • Texas can improve care and cut costs with the medical home

    Tags: budget, medical home, legislature, austin regional clinic, blue cross and blue shield of texas, payment

    Wednesday, March 2, 2011 3:00:00 AM
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    By Greg Sheff, M.D.

    I was fortunate to be one in a group of primary care physicians who met with Lt. Gov. David Dewhurst this February to discuss possibilities of payment reform in Medicaid, the Children’s Health Insurance Program, and the private insurance market.  This meeting comes on the heels of the introduction of two major pieces of legislation, Senate bills 7 and 8.  These bills would implement a host of pilot projects to test bundled payments, payments based on episodes of care, and quality incentives.  It continues the positive momentum the state needs to move us away from a fractured health care system into one that provides the right care for Texans.

    The unrelenting march of increasing health care costs is unsustainable, both for Texas and for the nation. Payment reform that aligns physician and hospital incentives with our society’s goals—affordable, coordinated, evidence-based, quality-measured care—is critical to rein in health care costs.  The patient-centered medical home, driven by a strong primary care workforce, is a proven cost-effective method for delivering this coordinated and integrated care.

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  • HHS Commissioner to Senate Finance: Spare primary care

    Tags: budget, legislature, payment

    Thursday, February 3, 2011 4:15:00 AM
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    When Tom Suehs, executive commissioner of Texas Health and Human Services, addressed the Senate Finance Committee in a hearing on Feb. 1, he told the 15 senators in no uncertain language that going through with cuts to primary care proposed in the Senate’s draft budget will damage access to care.

    Suehs (pronounced “seas”) is pushing for exceptional items that would reduce the cut in payment for primary care physicians treating kids enrolled in Medicaid and CHIP from 10 percent to 2 percent. This would cost the state around $125 million in general revenue next biennium, according to a Feb. 1 article in Quorum Report.

    “I’m really concerned about having to cut primary care rates for physicians treating children,” Suehs told the committee. “We’ve already cut 2 percent this biennium from when y’all wrote the [2010-2011] budget. I believe that’s about as far as I can tolerate to maintain the access to primary care so I’m asking to put back not all 10 percent, but 8 percent. Exceptional item 1A is for Medicaid children, exceptional item 1B is for CHIP.”

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  • Is it time to declare independence from the RUC?

    Tags: health care reform, medicare, ruc, payment

    Friday, January 28, 2011 10:00:00 AM
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    In a recent opinion column published in Kaiser Health news, two prominent voices in health care policy gave primary care physicians a piece of revolutionary advice: Quit the RUC.

    If you don’t know what the RUC is, you aren’t alone.

    RUC stands for the Relative Value Scale Update Committee, a group of 29 physicians from various medical specialties that meets three times a year to advise the Centers for Medicare and Medicaid Services on Medicare physician fee reimbursement and how certain procedures should be valued. Created by the American Medical Association in 1991, the committee has no official government standing, yet it yields great power.

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