Healthy Vision 2020
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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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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, 2014 7:32 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, 2014 7:34 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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The medical home requires building a better team

The medical home requires building a better team | Healthy Vision 2020 | Scoop.it
How do we get the many disparate members of our healthcare team together to provide better care in a patient-centered medical home?
Texas Medical Association's insight:

Right Care, Right Person, Right Time, Right Place

 

No one worries about the spiraling cost of U.S. health care more than physicians. Our current health care delivery system does too little to coordinate care for patients with expensive-to-manage chronic conditions. We don’t make the most effective use of allied health practitioners. We are requiring physicians to invest in high-dollar health information technology (HIT) systems without ensuring that the investment translates into better patient care. We are responding to calls to measure a physician’s effectiveness and efficiency but are concerned that the measures are not focusing on the right metrics. The way to save money in health care is not through ill-advised, random rationing of care, but rather through systems that ensure the right professional provides the right care, at the right place, and at the right time.

 

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Report: NPs, PAs won't solve primary care shortage

Report: NPs, PAs won't solve primary care shortage | Healthy Vision 2020 | Scoop.it
The industry still needs policies to solve the primary care shortage since more nurse practitioners (NPs) and physician assistants (PAs) are choosing subspecialty careers, according to new research from the American Academy of Family Physicians.
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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Primary Care Doctor Shortage Set To Get Worse, USA

Primary Care Doctor Shortage Set To Get Worse, USA | Healthy Vision 2020 | Scoop.it
Too few newly qualified doctors are choosing primary care, resulting in a serious shortage of primary care physicians in America. Federal funding needs to be changed.
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Jim Landers: Texas and Mexico both face obesity and diabetes emergencies

Jim Landers: Texas and Mexico both face obesity and diabetes emergencies | Healthy Vision 2020 | Scoop.it
Good news on obesity and diabetes in Texas? Not entirely. Bad news in Mexico? Definitely.
Texas Medical Association's insight:

Encourage Texans to take personal responsibility for their own health

 

Texas needs to support our citizens in taking more responsibility for their health and health care decisions.

 

The key to maintaining health lies in helping patients assume responsibility for their own health with regular support from their physicians. Competent, compassionate medical care, delivered with professionalism, state-of-the-art clinical knowledge, and patient respect are critical components of this responsibility. Conversely, patients have a responsibility to make informed, healthy decisions.

 

Physicians must continue to emphasize the importance and power of personal responsibility in patients’ health outcomes. Over the past century, public health interventions have effectively reduced and, in some cases, eliminated illness and death. We must use education and preventive medicine measures to go further — to curb the need for the complex treatment required once a preventable condition develops. Each occurrence of preventable chronic disease is costly to Texas’ government and businesses, to our economy, and to our people.

 

Personal health and wellness depend on the behavioral decisions we make as well as the social and environmental factors to which we are exposed throughout a lifetime. Four out of 10 Texas adults report at least one factor — high cholesterol, obesity, high blood pressure, a sedentary lifestyle, or a smoking habit — that puts them at high risk of developing a chronic disease. Many adults have more than one risk factor and can develop multiple chronic conditions.

 

These chronic diseases are killers that strike down Texans before their time. Tobacco, for instance, is directly responsible for the death of 24,000 Texans each year. This is more than homicide, HIV, suicide, influenza and pneumonia, accidents, and diabetes — combined.

 

Patients and their families trust their physicians to guide and influence decisions made to protect the patient’s health. However, with the massive information and misinformation in today’s super technology-driven environment, each patient and family needs the truth. Health literacy — patients’ education and ability to read, follow instructions, and communicate verbally — also affects their health. Nine out of 10 adults struggle with fully understanding basic health information as seen in advertisements, stores, the news, and in their communities.

 

All physicians and health care providers need to educate themselves on the cross-cultural dynamics that can impact a patient’s understanding and compliance with treatment. So, too, must the government’s education efforts evolve to accommodate the diverse cultures among poorer populations to ensure materials and programs connect with our population.

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Obesity's death toll could be higher than believed, study says

Obesity's death toll could be higher than believed, study says | Healthy Vision 2020 | Scoop.it
The death toll of the nation's obesity epidemic may be close to four times higher than has been widely believed, and all that excess weight could reverse the steady trend of lengthening life spans for a generation of younger Americans, new...
Texas Medical Association's insight:

Invest in obesity control

 

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.

 

The obesity epidemic, and the ever-younger age groups that it strikes, threatens Texas’ physical and fiscal health. Texas’ continually expanding waistline correlates to our health care cost demands. Obesity is responsible for 27 percent of the growth in health care spending. Treating obese patients costs 37 percent more than treating normal-weight patients.

 

The rise in overweight and obesity is affecting the bottom line of Texas employers. The Texas Comptroller’s Office found that in 2009, obesity cost Texas businesses an estimated $9.5 billion, due to higher employee insurance costs, absenteeism, and other effects. Left unchecked, obesity could cost employers $32.5 billion annually by 2030.

 

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.”

 

A great proportion of obese adults were overweight or obese as children. This serious risk factor is found in Texas, where more than 30 percent of children in grades 4 through 11 are overweight or obese. A child who is overweight at age 12 has a 75-percent chance of being overweight as an adult.

 

There is no single solution to preventing or addressing obesity. Multiple evidence-based approaches must be pursued for physicians, communities, schools, and workplaces, and each must identify potential barriers to implementing local programs

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State and Local Coverage Changes Under Full Implementation of the Affordable Care Act

State and Local Coverage Changes Under Full Implementation of the Affordable Care Act | Healthy Vision 2020 | Scoop.it
Medicaid Enrollment Increases Under the ACA The demographic composition of Medicaid enrollees shifts under the ACA Nationally, our model projects a 37.4 percent increase in Medicaid/CHIP enrollment under the ACA, with total enrollment rising from...
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Federal Regulator, Meet Dr. Regulated

Perhaps it’s time for federal regulators to examine themselves, because it certainly appears there’s too much oversight that inhibits phys
Texas Medical Association's insight:

After “health,” the most frequently used word in the Patient Protection and Affordable Care Act (PPACA) is neither “patient” nor “physician” nor “hospital” nor “insurance.” “Secretary,” as in “the secretary of health and human services,” is mentioned more than 2,500 times in the 2,300-page bill. And more than 700 times, the PPACA says “the secretary shall.” Each of these directives is a sign of new regulations to come on physicians and health care. Unfortunately, the PPACA was not the genesis of physician regulation, nor are these busy rulemakers limited to the federal government. “An extensive regulatory framework … arose haphazardly, with little consideration of how the pieces fit together,” the Federal Trade Commission and U.S. Department of Justice reported in 2004. The huge numbers of state and federal regulations and their haphazard nature place tremendous burdens on physicians’ practices, most of which are still small businesses. These rules insert themselves between physicians and their patients, frequently do little to improve patient care, and divert physicians’ time and energy away from the patients in the exam room. We need to repeal, reorganize, and reprioritize if we want a functional health care delivery system.

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Medicare’s Sustainable Growth Rate: Principles for Reform

Medicare’s Sustainable Growth Rate: Principles for Reform | Healthy Vision 2020 | Scoop.it
Congress will soon revisit the issue of Medicare physician reimbursement. Much of the discussion will focus on the sustainable growth rate (SGR), enacted in 1997 as a mechanism to update yearly Medicare physician payments.
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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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Criminally negligent physical education

Did it really take the American Medical Association to tell us this? The AMA has pronounced childhood obesity a disease — also, that boiling water scalds and wood splinters.
Texas Medical Association's insight:

Invest in obesity control

 

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.

 

The obesity epidemic, and the ever-younger age groups that it strikes, threatens Texas’ physical and fiscal health. Texas’ continually expanding waistline correlates to our health care cost demands. Obesity is responsible for 27 percent of the growth in health care spending. Treating obese patients costs 37 percent more than treating normal-weight patients.

 

The rise in overweight and obesity is affecting the bottom line of Texas employers. The Texas Comptroller’s Office found that in 2009, obesity cost Texas businesses an estimated $9.5 billion, due to higher employee insurance costs, absenteeism, and other effects. Left unchecked, obesity could cost employers $32.5 billion annually by 2030.

 

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.”

 

A great proportion of obese adults were overweight or obese as children. This serious risk factor is found in Texas, where more than 30 percent of children in grades 4 through 11 are overweight or obese. A child who is overweight at age 12 has a 75-percent chance of being overweight as an adult.

 

There is no single solution to preventing or addressing obesity. Multiple evidence-based approaches must be pursued for physicians, communities, schools, and workplaces, and each must identify potential barriers to implementing local programs.

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This is why controlling health-care costs is almost impossible

This is why controlling health-care costs is almost impossible | Healthy Vision 2020 | Scoop.it
Americans aren't angry about health-care costs. They're angry about the small fraction of health-care costs they directly pay.
Texas Medical Association's insight:

"The health-care financing system is so fractured that it’s entirely possible for costs to fall overall even as they look like they’re rising to families. The cost control efforts in Obamacare — or in any serious replacement — will mean, among other things, higher deductibles, tighter networks and more aggressively managed care."

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Twitter / texmed: Vaccines Don't Cause Autism ...

Texas Medical Association's insight:

Not vaccinating your child against a disease like the measles is bad for your child and bad for those around you. Listen to some science, check out the video: http://youtu.be/aN0N5tTIFeI

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Regulation nation: Obama expands the regulatory state

Regulation nation: Obama expands the regulatory state | Healthy Vision 2020 | Scoop.it
The reach of the executive branch has advanced steadily under Obama, further solidifying the power of federal bureaucrats. President Obama has overseen a dramatic expansion of the regulatory state that will outlast his time in the White House.
Texas Medical Association's insight:

After “health,” the most frequently used word in the Patient Protection and Affordable Care Act (PPACA) is neither “patient” nor “physician” nor “hospital” nor “insurance.” “Secretary,” as in “the secretary of health and human services,” is mentioned more than 2,500 times in the 2,300-page bill. And more than 700 times, the PPACA says “the secretary shall.” Each of these directives is a sign of new regulations to come on physicians and health care. Unfortunately, the PPACA was not the genesis of physician regulation, nor are these busy rulemakers limited to the federal government. “An extensive regulatory framework … arose haphazardly, with little consideration of how the pieces fit together,” the Federal Trade Commission and U.S. Department of Justice reported in 2004. The huge numbers of state and federal regulations and their haphazard nature place tremendous burdens on physicians’ practices, most of which are still small businesses. These rules insert themselves between physicians and their patients, frequently do little to improve patient care, and divert physicians’ time and energy away from the patients in the exam room. We need to repeal, reorganize, and reprioritize if we want a functional health care delivery system.

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Prevention Means Business

Prevention Means Business | Healthy Vision 2020 | Scoop.it
Texas Medical Association's insight:

TMA Recommendations

 

•    Actively involve patients in the health care decisionmaking process.

•    Promote participation in smoking cessation programs, worksite wellness, and routine screenings.

•    Provide incentives via merit grants that recognize those state agencies that are promoting productive worksite wellness efforts.

•    Continue full funding for the Texas Women’s Health Program.

•    Streamline efforts to vaccinate people who work with high-risk populations.

•    Support statutory changes that allow parents of Texas schoolchildren access to data specific to the schools their children attend regarding the number of conscientious objector claims to vaccination.

•    Improve access to vaccinations, including improvements in the state’s Vaccines for Children Program and the adult safety net programs; this will ensure uninsured and low-income persons can get appropriate vaccinations.

•    Keep public health disease surveillance systems robust.

•    To address the growing obesity problem in Texas, increase funding for improving access to healthy foods; increase access to parks and recreational facilities; and promote worksite wellness policies.

•    Reduce or prevent childhood obesity by increasing physical activity and reducing barriers to student participation in safe school sport activities.

•    Promote physician participation in school health advisory committees and other public health prevention programs. Support legislation that requires inclusion of a primary care physician on all school health advisory committees.

•    Require Texans who smoke and communities that allow it in public venues to fund an increasing portion of health care costs related to smoking-related illnesses.

•    Adequately fund proven interventions to reduce tobacco use, such as Texas’ Quitline and education in schools.

•    Provide smoking cessation benefit coverage for state employees and retired teachers.

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Rural Physician Training Programs Can Inspire Future Rural Practice

After medical school students spent a summer practicing in a rural community, they were more likely to enter family practice residency training and begin their medical careers in a rural location, according to a recent study.
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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Depression Costs U.S. Workplaces $23 Billion in Absenteeism

Depression Costs U.S. Workplaces $23 Billion in Absenteeism | Healthy Vision 2020 | Scoop.it
U.S. workers with depression miss an estimated 68 million additional days of work each year compared with those who have never been diagnosed, resulting in an estimated cost of more than $23 billion in lost productivity annually.
Texas Medical Association's insight:

Invest in mental health and substance abuse community treatment

 

Mental illness and substance abuse hurt the Texas economy through lost earning potential, treatment of coexisting conditions, disability payments, homelessness, and incarceration.

 

Mental illness is a leading cause of disability in the United States. About 13 million adults have a debilitating mental illness each year, and almost half of all adults will be affected by mental illness in their lifetime. Five percent of adults have a serious mental illness.About one in five children are affected by a mental health disorder with severe impairment in their lifetime.

 

More than 8 percent of Texas adults report current depression, and 5.2 percent report serious psychological distress. In 2011, almost 30 percent of Texas high school students reported they felt sad or hopeless almost every day for at least two weeks. Suicide is a leading cause of death among Texans under 35 years.

 

More than 66,000 Texans were cared for in state-funded substance abuse treatment programs in 2010. Substance use is common in Texas students (grades 7-12), with 62 percent reporting they had used alcohol and 17.2 reporting inhalant abuse. Despite significant legislation to curtail drinking and driving, almost 40 percent of Texas driving fatalities are still associated with alcohol use.

 

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.

 

Mental illness is also strongly associated with high-risk behaviors such as alcohol, tobacco, and illicit drug use, and results in conditions such as obesity. U.S. mental health costs were estimated to be $57.5 billion in 2006 including the cost of mental health care and the indirect costs of disability caused by mental illness. One recent study estimates that Texas state dollars spent on mental health exceed $13 billion each year.

 

Mental health treatment costs in the United States totaled almost $9 billion in children in 2006; Medicaid covered more than one-third of these costs.

 

Proper care for persons with mental illnesses saves costs associated with the cycle of incarceration, homelessness, and so forth. Assessing the return on investment connected with mental health and substance abuse care is complex because there are many different diagnoses, and the disability caused by each and the treatment plans vary greatly. In 2003, depression cost U.S. employers $44 billion in lost productivity alone. One employee assistance program in California showed a return on investment of $5.17 to $6.47 for every dollar spent on employee assistance for a mental health problem.

 

While Texas has recently made significant investments in community mental health services, we still rank 50th in state public mental health funding per capita.

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