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Interactive: Mapping Texans' Access to Health Care

Interactive: Mapping Texans' Access to Health Care | Healthy Vision 2020 | Scoop.it

Access to health care is scant across the vast rural regions of Texas, and it's a problem on track to worsen. Doctors, pharmacists and family planning clinics say state budget tightening may force many health care providers out of business or prevent them from providing adequate patient care. There's also fear that Texas medical schools won't produce enough primary care doctors to support the growing population and that there will not be enough residency positions for Texas medical students in the coming years.

 

Texas is HUGE! Many parts of this giant state are lacking the physicians they need to care for our growing population. This interactive map from the Texas Tribune gives you a county-by-county and specialty-by-specialty look at where our biggest problems are.

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Healthy Vision 2020
Bringing into focus a clear and distinct view of the rest of this decade in Texas health care. Offering a sharp perception of what lies ahead and what we must change to keep us all healthy.
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Avoiding Medicaid expansion, lawmakers seek a ‘Texas way’

Avoiding Medicaid expansion, lawmakers seek a ‘Texas way’ | Healthy Vision 2020 | Scoop.it
Texas lawmakers are exploring ways the state could provide more access to health care for 1.9 million uninsured poor people without acquiescing to guidelines set under the Affordable Care Act, sometimes referred to as Obamacare.
Texas Medical Association's insight:

Texas physicians want to ensure all Texans have access to coverage and, more importantly, access to physicians and health care providers. According to the Institute of Medicine, even when uninsured patients have access to safety net services, the lack of health insurance results often results in delayed diagnoses and treatment of chronic diseases or injuries, needless suffering and even death. That’s why TMA supports allowing state leaders to work with the Centers for Medicare & Medicaid Services (CMS) to develop a comprehensive solution that fits Texas’ unique health care needs. Several states have taken this step with some success, including Indiana, Arkansas, Iowa, Michigan, and Pennsylvania . TMA believes the Texas Legislature too can create an ingenious solution that works for the state and helps Texans in the coverage gap get affordable and timely care.

 

Any Texas-style solution expanding access must:

Draw down all available federal dollars to expand access to health care for poor Texans;Give Texas the flexibility to change the plan as our needs and circumstances change;Clear away Medicaid’s financial, administrative, and regulatory hurdles that are driving up costs and driving Texas physicians away from the program;Relieve local Texas taxpayers and Texans with insurance from the unfair and unnecessary burden of paying the entire cost of caring for their uninsured neighbors;Provide Medicaid payments directly to physicians at least equal to those of Medicare payments; andContinue to uphold and improve due process of law for physicians in Texas as it relates to the Office of Inspector General.
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Texas Medical Association's curator insight, August 15, 5:38 AM

Texas physicians want to ensure all Texans have access to coverage and, more importantly, access to physicians and health care providers. According to the Institute of Medicine, even when uninsured patients have access to safety net services, the lack of health insurance results often results in delayed diagnoses and treatment of chronic diseases or injuries, needless suffering and even death. That’s why TMA supports allowing state leaders to work with the Centers for Medicare & Medicaid Services (CMS) to develop a comprehensive solution that fits Texas’ unique health care needs. Several states have taken this step with some success, including Indiana, Arkansas, Iowa, Michigan, and Pennsylvania. TMA believes the Texas Legislature too can create an ingenious solution that works for the state and helps Texans in the coverage gap get affordable and timely care.

 

Any Texas-style solution expanding access must:

Draw down all available federal dollars to expand access to health care for poor Texans;Give Texas the flexibility to change the plan as our needs and circumstances change;Clear away Medicaid’s financial, administrative, and regulatory hurdles that are driving up costs and driving Texas physicians away from the program;Relieve local Texas taxpayers and Texans with insurance from the unfair and unnecessary burden of paying the entire cost of caring for their uninsured neighbors;Provide Medicaid payments directly to physicians at least equal to those of Medicare payments; andContinue to uphold and improve due process of law for physicians in Texas as it relates to the Office of Inspector General.
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Mental illness cases swamp criminal justice system

Mental illness cases swamp criminal justice system | Healthy Vision 2020 | Scoop.it
Inside a cluttered downtown apartment that she shares with a cat, the 57-year-old woman is in the midst of a near-meltdown.
Texas Medical Association's insight:

In 2009, 23 percent of the adult offenders in Texas state prisons, on parole, or on probation were current or former clients of the Texas public mental health system. A Texan with a serious mental illness is eight times more likely to be in a jail than in a hospital or treatment program, at a cost of $50,000 a year. A person in jail without a mental illness costs the state about $22,000 annually.

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This Is Our Youth - Out of Shape

This Is Our Youth - Out of Shape | Healthy Vision 2020 | Scoop.it
Young Americans are becoming less aerobically fit with every year, with only 42 percent of 12- to 15-year-olds in a new study making it into the “healthy fitness zone.”
Texas Medical Association's insight:

Overweight and obesity contribute to diabetes, hypertension, heart disease, cancer, and stroke. Texas has an easy-to-see obesity crisis. Some 66 percent of Texas adults are overweight or obese; the United States average is 63 percent. During the past three decades, obesity rates in children have more than tripled in the country. Today, 32 percent of Texas children (ages 10-17) are obese.

 

Improved physical health in students has been linked to academic success. Conversely, children with obesity are more prone to absences and lower grades. In the United States, students who are physically active at least 60 minutes on most days, play on at least one sports team, or watch fewer than three hours of television per day consistently have “mostly A’s.”

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How Meaningful Is Meaningful Use?

How Meaningful Is Meaningful Use? | Healthy Vision 2020 | Scoop.it
How Meaningful Is Meaningful Use?



SUBHEAD: Government programs encouraging the use of electronic health records are out of synch with reality.
Texas Medical Association's insight:

TMA Says: 

The cost to operate a physician’s office continues to climb unabated. Unfunded mandates and hidden regulatory burdens like the ongoing hassles of annually renewing state registration to continue to prescribe needed medications for patients threaten the viability of practices and patients’ access to care. The average cost to staff and run a practice now exceeds $500,000 per physician, and that’s before the physician gets paid a dime. These excessive administrative expenses add to the escalating cost of medical care that are borne by patients, employers, and taxpayers.

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NH Senate OKs Medicaid money for private coverage

The New Hampshire Senate on Thursday approved using federal Medicaid money to buy private health insurance for thousands of poor adults, with supporters emphasizing the benefits to the state’s economy and the health of its residents and opponents arguing taxpayers would be stuck with the bill when federal money drops off.
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New Rule Creates Avalanche Of Time-Wasting Paperwork For Doctors

Texas Medical Association's insight:

TMA says: Put ICD-10 on permanent hold


The ICD-10 requirement is an excellent example of a costly regulation that will disrupt practice operations. ICD-10 is a 20-year-old boondoggle of a system that will help only health care researchers. Before Secretary Sebelius delayed the new coding language for an additional year, the federal government announced that all physicians, hospitals, providers, and insurance companies must shift from ICD-9 to ICD-10 no later than Oct. 1, 2013. The punishment for noncompliance is severe: no payment for any medical services provided.

 

The number of diagnostic codes that physicians would be required to use under ICD-10 would grow from 13,500 to 69,000. The number of codes for inpatient procedures also would soar from 4,000 to 71,000. For example, the new system has 480 codes for a fractured knee cap — up from a grand total of two in ICD-9. Switching to ICD-10 will mandate extensive revision of physicians’ paper and electronic systems. Transition to the new system is expected to cost solo physicians as much as $83,000 each, and group practices of up to 10 doctors as much as $250,000.

 

The ICD-10 mandate will create significant burdens on the practice of medicine with no direct benefit to individual patient care. It is a huge weight to place on physicians when they face numerous other administrative hurdles, including implementing and achieving meaningful use of electronic health records (EHRs), meeting quality measures under Medicare’s PQRS and other programs, the impending creation of accountable care organizations in Medicare, and more. The timing of the transition could not be worse, as many physicians already are spending significant time and resources implementing EHRs in their practices.

 

ICD-10 is old technology developed during the 1980s and not designed to work in the current electronic world. A new version of the diagnostic and procedure codes, ICD-11, could come as early as 2015. It is being designed for use with electronic health records and the Internet, and should be more user-friendly than ICD-10. 

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The Medical Home's Impact on Cost & Quality

The Medical Home's Impact on Cost & Quality | Healthy Vision 2020 | Scoop.it
Texas Medical Association's insight:

TMA supports the use of the PCMH model in Medicare, Texas Medicaid, and commercial insurance plans. Public and private payers have, increasingly, been looking to this model as a way to reduce fragmented care, lower costs, avoid repetitive and costly procedures, and improve patient outcomes. Given the budget constraints that Texas faces and a growing population with unique health care needs, the PCMH offers the potential for Medicaid cost savings as well as improved patient outcomes and physician and provider satisfaction. 

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SGR proposals include rewards for medical homes

SGR proposals include rewards for medical homes | Healthy Vision 2020 | Scoop.it
The proposals to scrap Medicare's sustainable growth-rate formula for updating physician pay include less-noticed provisions rewarding practices that operate as a patient-centered medical home. There is a twist, however.
Texas Medical Association's insight:

As public and private payers look for ways to lower costs, improve patient outcomes, and ease burdens to access, they are turning to models of care that both increase economic efficiencies and enhance patient care. One of these is the patient-centered medical home (PCMH) model. A PCMH is a primary care physician or physician-led team who ensures that patient care is accessible, coordinated, comprehensive, patient-centered, and culturally relevant. The physician or team directly provide, coordinate, or arrange health care or social support services as indicated by the patient’s individual medical needs and the best available medical evidence. The model uses a team-based approach with the patient’s primary care physician leading the overall coordination of care. Trained teams and well-constructed electronic health records (EHRs) are key to a successful PCMH.

 

TMA supports the use of the PCMH model in Medicare, Texas Medicaid, and commercial insurance plans. Public and private payers have, increasingly, been looking to this model as a way to reduce fragmented care, lower costs, avoid repetitive and costly procedures, and improve patient outcomes. Given the budget constraints that Texas faces and a growing population with unique health care needs, the PCMH offers the potential for Medicaid cost savings as well as improved patient outcomes and physician and provider satisfaction. 

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Texas among states adding most new physicians - Austin Business Journal

Texas among states adding most new physicians - Austin Business Journal | Healthy Vision 2020 | Scoop.it
Although many experts say the Lone Star State is facing a shortage of doctors down the road, Texas is adding physicians who treat patients faster than all but one state.
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Residency Slots: A Crisis in the Making?

Residency Slots: A Crisis in the Making? | Healthy Vision 2020 | Scoop.it
As the number of medical students grows without a commensurate increase in residency slots, medical schools, teaching hospitals, states, and thought leaders are working on ways to increase the number
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Study Points To “Imbalance” In Spending On Doctor Training – Capsules - The KHN Blog

Study Points To “Imbalance” In Spending On Doctor Training – Capsules - The KHN Blog | Healthy Vision 2020 | Scoop.it
Texas Medical Association's insight:

New York state received 20 percent of all Medicare’s graduate medical education funding while 29 states, including places struggling with a severe shortage of physicians, got less than 1 percent, the study said. Other states at the top of the heap in funding are Massachusetts, Rhode Island, Pennsylvania, Michigan and Connecticut, the study found. Each of these states gets more than $71 in funding per each resident compared to $14 for Florida and $11.50 for Texas. At the bottom is Montana, which gets $1.94 per resident.

The distribution is important because while some medical residents move elsewhere after training, most practice near where they train. Doctors enter medical residency typically for three or more years after they graduate from medical school.

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AMA: The administrative burden of being a physician

AMA: The administrative burden of being a physician | Healthy Vision 2020 | Scoop.it
New data released by the American Medical Association (AMA) ranks major health insurers according to their administrative cost burdens.
Texas Medical Association's insight:

TMA Recommendations

•    Put ICD-10 on permanent hold until ICD-11 or another appropriate replacement for ICD-9 is ready for widespread implementation.

•    Require government agencies to consider the disruption that new regulations and penalties introduce into medical practices and refrain from introducing new hurdles. The one-year delay of ICD-10 was a step in the right direction.

•    Protect physicians who care for chronically ill or noncompliant patients from quality-of-care measures that do not account for such variances in patient populations. Stop implementation of Medicare’s “value-based purchasing” program, unless physicians who treat these populations are treated fairly.

•    Protect tax law provisions that acknowledge physicians’ unique roles in caring for all patients — this includes physicians who provide charity care.

•    Repeal legislation that limits physician ownership of hospitals.

•    Promote responsible ownership of all health care facilities, whether owned by a physician, hospital, or other provider. 

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Editorial: IPAB could get help from Mass. cost-control panel

Editorial: IPAB could get help from Mass. cost-control panel | Healthy Vision 2020 | Scoop.it
Amid all the anger aimed at the Patient Protection and Affordable Care Act, no aspect of that wide-ranging statute has drawn more ire than the Independent Payment Advisory Board.
Texas Medical Association's insight:

Our position: Repeal the Independent Payment Advisory Board


Replacing the SGR will be meaningless unless Congress also repeals the Independent Payment Advisory Board (IPAB). Leaving both in place would create cruel and unusual double jeopardy for physicians who want to care for senior citizens and military families. The PPACA created a 15-member IPAB to recommend measures to reduce Medicare spending if costs exceed targeted growth rates set by the Centers for Medicare & Medicaid Services (CMS).

 

The PPACA prohibits the panel from recommending changes to eligibility, coverage, or other factors that drive utilization of health care services. This means the board will have only one option — cut payments. And through 2019, hospitals, Medicare Advantage plans, Medicare prescription drug plans, and health care professionals other than physicians are exempt.This means the board will have only one option — cut Medicare payments to physicians. Cuts the board recommends will automatically take effect, unless Congress acts to suspend them.

 

As we’ve seen with the SGR, it’s obvious that cuts the IPAB enacts will devastate Medicare beneficiaries’ ability to find physicians to care for them. The issue of Medicare spending for 3.8 million Texans is too important to be left in the hands of an unaccountable board that makes decisions based solely on cost. 

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Big Tobacco Successfully Increasing E-Cigarette Use In Youths

Big Tobacco Successfully Increasing E-Cigarette Use In Youths | Healthy Vision 2020 | Scoop.it
Don't fool yourself: smoking electronic cigarettes is still smoking.
Texas Medical Association's insight:

Electronic cigarettes or “e-cigarettes” are widely accessible and growing in popularity. Several states have already passed legislation to include e-cigarettes in nonsmoking laws or to restrict the sale of e-cigarettes to minors. TMA is calling on lawmakers to restrict the purchase of e-cigarettes by minors, adopt appropriate regulations for e-cigarettes, and ensure current smoking prohibitions include e-cigarettes. Physicians are concerned that the use of e-cigarettes could be a pathway to future tobacco use and nicotine addiction.


 

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Medicare physicians and providers complain of duplicative audits

[The Associated Press] MIAMI — Health care companies say they're losing millions of dollars that are tied up in appeals because of increasing numbers of Medicare audits. But the rise in the often duplicative audits has failed to reduce Medicare fraud, according to a ...
Texas Medical Association's insight:
RACs are bounty hunters. They receive a healthy commission on every claim they deny.RACs don’t have a medical license. Personnel with little to no expertise in medical care conduct the reviews, which helps to explain why “overpayment determinations” are being overturned at an alarming rate. Only physicians should be allowed to decide whether a physician service was medically necessary.RACs are not held accountable. They should be penalized for erroneous overpayment determinations and should be required to reimburse physicians for the costs incurred in defending against a recovery audit when an appeal is won. According to CMS, the RAC loses 43 percent of the time when a physician or provider appeals a recovery audit overpayment claim. Physicians should not bear the cost of legal and administrative fees to pursue appeals, especially when they win the appeal.
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Getting Rural Patients Psychiatric Help Fast - Kaiser Health News

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Nebraska governor vetoes bill to ease restrictions on nurse practitioners

Nebraska governor vetoes bill to ease restrictions on nurse practitioners | Healthy Vision 2020 | Scoop.it
LB 916, which passed the Legislature 43-0, would have eliminated the requirement that nurse practitioners have a practice agreement with a doctor.
Texas Medical Association's insight:

Texas has a large, growing population that is growing sicker and needs more and better-coordinated health care services. Unfortunately, Texas — even more than most of the rest of the country — needs more physicians and other health care professionals. Although our 2003 liability reforms have brought an influx of new physicians, the current supply won’t be able to keep up with the demand, especially with expanded insurance coverage from the Patient Protection and Affordable Care Act (PPACA). We need more physicians and other health care professionals working in all parts of the state, especially in rural and border Texas. We need to invest more in our medical schools and graduate medical education training programs. We should not fool ourselves into thinking that allied health professionals — who haven’t gone to medical school — can fill the gap as independent practitioners. Instead, we need to work on building physician-led health care teams that can safely meet the diverse needs of the Texas population.

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Corbett shifts on PA Medicaid proposal’s work search

Gov. Tom Corbett appeared ready Thursday to drop one of the most controversial conditions of his proposal to accept billions of federal Medicaid expansion dollars and extend taxpayer-subsidized insurance to hundreds of thousands of working poor in Pennsylvania.
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FDA unveils its $115 million anti-smoking campaign targeting teens

FDA unveils its $115 million anti-smoking campaign targeting teens | Healthy Vision 2020 | Scoop.it
The national effort is aimed at preventing 12-to-17-year-olds from becoming “replacement customers.”
Texas Medical Association's insight:

More than 24,000 Texans die each year from smoking-related illness. Tobacco is the single greatest cause of preventable and premature death and illness in the world. Adults who smoke are at substantially greater risk of developing chronic diseases and conditions including multiple types of cancer, increasing their risk of diabetes complications, cardiovascular disease, and stroke. Children exposed to secondhand smoke are more likely to develop respiratory problems and acute illnesses. Almost every major system in your body is affected by smoking or secondhand smoke. 

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Uninsured, patients with public coverage have trouble finding doctors

Uninsured, patients with public coverage have trouble finding doctors | Healthy Vision 2020 | Scoop.it
Uninsured adults and those with public health coverage have a harder time finding a primary-care physician who will take them as a patient compared with people who have private insurance, government data shows.That raises questions about whether...
Texas Medical Association's insight:

Texas has a large, growing population that is growing sicker and needs more and better-coordinated health care services. Unfortunately, Texas — even more than most of the rest of the country — needs more physicians and other health care professionals. Although our 2003 liability reforms have brought an influx of new physicians, the current supply won’t be able to keep up with the demand, especially with expanded insurance coverage from the Patient Protection and Affordable Care Act (PPACA). We need more physicians and other health care professionals working in all parts of the state, especially in rural and border Texas. We need to invest more in our medical schools and graduate medical education training programs. We should not fool ourselves into thinking that allied health professionals — who haven’t gone to medical school — can fill the gap as independent practitioners. Instead, we need to work on building physician-led health care teams that can safely meet the diverse needs of the Texas population.

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Oregon health care professionals could get big help in repaying loans

Oregon health care professionals could get big help in repaying loans | Healthy Vision 2020 | Scoop.it
Health care providers who agree to work in Oregon where there’s a shortage of ...
Texas Medical Association's insight:

Physician shortages constitute a special problem in rural areas of the state. The continued urbanization of Texas exacerbates this longstanding problem. Approximately 12 percent of Texans live in rural counties, yet only 10 percent of primary care physicians practice there. In 2011, Texas had 52 primary care physicians per 100,000 population in rural areas versus 72 per 100,000 in urban areas. Physician shortages in rural areas not only hinder access to primary and other specialty care but also lead to potential losses in the local economy, difficulties attracting new businesses, and diminished quality of life for residents. A number of factors hurt physicians’ ability to open and sustain rural practices, including heavy concentration of Medicare, Medicaid, and uninsured patients; professional isolation; and high debt after medical school.

 

Physician practices in rural Texas contribute to the local economy in three critical ways.

 

• They employ administrative and clinical staff to help care for patients. On average, a solo primary care physician in a rural area will employ three staff: a registered nurse, a medical technician or licensed vocational nurse, and a receptionist/billing clerk.

• They contribute revenue to and generate additional employment at local hospitals through inpatient admissions and outpatient services.

• They generate essential tax revenues for their communities.

 

If rural physician practices and rural economies are to thrive, physicians need incentives to practice in those areas. Medical school programs with rural-focused curricula increase the supply of primary care doctors in underserved areas as do loan forgiveness programs like the National Health Service Corps and the State Physician Education Loan Repayment Program (SPELRP).

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American Health Care: Too Much, Too Late?

American Health Care: Too Much, Too Late? | Healthy Vision 2020 | Scoop.it
What if we could reduce our reliance on treatments and direct more resources to the services that improve people’s health in the first place?
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Doctor demand will grow by up to a third by 2025 - study

Doctor demand will grow by up to a third by 2025 - study | Healthy Vision 2020 | Scoop.it
NEW YORK (Reuters Health) - Driven by an aging population and increased access to health insurance, the U.S.
Texas Medical Association's insight:

TMA Recommendations

• Preserve and protect state support for undergraduate medical education and the cultivation of the future generation of Texas physicians, thus ensuring stable access to health care for all Texans.

• Support and develop new graduate medical education programs in the specialties that best reflect the state’s health care needs. Support incentives for hospitals and other community-based agencies to develop residency programs in the specialties most needed.

• Direct the Texas Higher Education Coordinating Board to coordinate the availability of graduate medical education training positions so that Texas can retain our graduates for residency training.

• Sponsor research to identify and promote innovations in training primary care residents for practice in Texas, and to address the factors that influence why few U.S. medical school graduates select this training.

• Adjust the payment system for health care services to make primary care an attractive career option for those considering a rural practice.

• Reinstate the State Physician Education Loan Repayment Program funds that were slashed during the 2011 legislative session to encourage physicians to practice in rural and medically underserved communities.

• Strongly oppose any efforts to expand scope of practice beyond that safely permitted by nonphysician practitioners’ education, training, and skills.

• Support expansions of scope of practice laws that protect patient safety, are consistent with team care, are based on objective educational standards, and improve patient care services.

• Support legislation that strengthens the Texas Medical Board’s regulatory oversight of nonphysician licensees who, by objective educational improvements, are granted authority to perform acts traditionally reserved for and defined as the practice of medicine.

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Accuracy of coding in ICD-10 pilot varies, report says |
Modern Healthcare

Accuracy of coding in ICD-10 pilot varies, report says | <br/>Modern Healthcare | Healthy Vision 2020 | Scoop.it
Medical coders participating in an ICD-10 coding pilot produced accurate coding using the complex new system less than two-thirds of the time, according to a report by two healthcare IT industry groups.
Texas Medical Association's insight:

See full report: http://www.himss.org/files/HIMSSorg/Content/files/ICD-10_NPP_Outcomes_Report.pdf

 

TMA's position:

 

Put ICD-10 on permanent hold

 

The ICD-10 requirement is an excellent example of a costly regulation that will disrupt practice operations. ICD-10 is a 20-year-old boondoggle of a system that will help only health care researchers. All physicians, hospitals, providers, and insurance companies must shift from ICD-9 to ICD-10 no later than Oct. 1, 2014. The punishment for noncompliance is severe: no payment for any medical services provided.

 

The number of diagnostic codes that physicians would be required to use under ICD-10 would grow from 13,500 to 69,000. The number of codes for inpatient procedures also would soar from 4,000 to 71,000. For example, the new system has 480 codes for a fractured knee cap — up from a grand total of two in ICD-9. Switching to ICD-10 will mandate extensive revision of physicians’ paper and electronic systems. Transition to the new system is expected to cost solo physicians as much as $83,000 each, and group practices of up to 10 doctors as much as $250,000.

 

The ICD-10 mandate will create significant burdens on the practice of medicine with no direct benefit to individual patient care. It is a huge weight to place on physicians when they face numerous other administrative hurdles, including implementing and achieving meaningful use of electronic health records (EHRs), meeting quality measures under Medicare’s PQRS and other programs, the impending creation of accountable care organizations in Medicare, and more. The timing of the transition could not be worse, as many physicians already are spending significant time and resources implementing EHRs in their practices.

 

ICD-10 is old technology developed during the 1980s and not designed to work in the current electronic world. A new version of the diagnostic and procedure codes, ICD-11, could come as early as 2015. It is being designed for use with electronic health records and the Internet, and should be more user-friendly than ICD-10. 

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Rajat Dhameja's curator insight, June 14, 4:32 PM

October 1, 2014 and after, fractured knee cap will have 480 codes in ICD - 10, up from 2 in ICD- 9

Rajat Dhameja's curator insight, June 14, 4:34 PM

October 1, 2014 and after, fractured knee cap will have 480 codes in ICD - 10, up from 2 in ICD- 9

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Student loan forgiveness to keep doctors in N.J? It could happen

Student loan forgiveness to keep doctors in N.J? It could happen | Healthy Vision 2020 | Scoop.it
The bill is based on a recommendation in a report issued by the New Jersey Council of Teaching Hospitals that said loan forgiveness is one of the top factors that medical residents look for in determining a practice.
Texas Medical Association's insight:

Improve rural access to care

 

Physician shortages constitute a special problem in rural areas of the state. The continued urbanization of Texas exacerbates this longstanding problem. Approximately 12 percent of Texans live in rural counties, yet only 10 percent of primary care physicians practice there. In 2011, Texas had 52 primary care physicians per 100,000 population in rural areas versus 72 per 100,000 in urban areas. Physician shortages in rural areas not only hinder access to primary and other specialty care but also lead to potential losses in the local economy, difficulties attracting new businesses, and diminished quality of life for residents. A number of factors hurt physicians’ ability to open and sustain rural practices, including heavy concentration of Medicare, Medicaid, and uninsured patients; professional isolation; and high debt after medical school.

 

Physician practices in rural Texas contribute to the local economy in three critical ways.

 

• They employ administrative and clinical staff to help care for patients. On average, a solo primary care physician in a rural area will employ three staff: a registered nurse, a medical technician or licensed vocational nurse, and a receptionist/billing clerk.

• They contribute revenue to and generate additional employment at local hospitals through inpatient admissions and outpatient services.

• They generate essential tax revenues for their communities.

 

If rural physician practices and rural economies are to thrive, physicians need incentives to practice in those areas. Medical school programs with rural-focused curricula increase the supply of primary care doctors in underserved areas as do loan forgiveness programs like the National Health Service Corps and the State Physician Education Loan Repayment Program (SPELRP).

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