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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F as in Fat: How Obesity Threatens America's Future 2012 - Trust for America's Health

The number of obese adults, along with related disease rates and health care costs, are on course to increase dramatically in every state in the country over the next 20 years, according to F as in Fat: How Obesity Threatens America's Future 2012, a report released by Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation (RWJF). 

 

“This study shows us two futures for America’s health,” said Risa Lavizzo-Mourey, MD, RWJF president and CEO. “At every level of government, we must pursue policies that preserve health, prevent disease and reduce health care costs. Nothing less is acceptable.”

 

For Texas, report estimates adult obesity rate could reach 57.2 percent by 2030. Related health care costs could climb by 17.4 percent.

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Houston-area school districts adopt new take on sex ed

Houston-area school districts adopt new take on sex ed | Healthy Vision 2020 | Scoop.it

Some Houston-area school districts are shifting away from traditional abstinence-only sex education classes this school year, part of a statewide trend that has prompted concern among some parents that kids are learning too much, too soon about sex.

 

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. 

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The Healthy Benefits of Texas Medical Liability Reform « D Healthcare Daily

The Healthy Benefits of Texas Medical Liability Reform « D Healthcare Daily | Healthy Vision 2020 | Scoop.it

It’s clockwork. Nine years ago this week, Texas voters approved our desperately needed medical liability reforms. Just like every other year at this time, the trial lawyers’ propaganda machine is once again trying to convince Texans to ignore the improvements they’re seeing all around them.

I’m pleased to report on some new research that soundly contradicts the naysayers’ rhetoric.

 

In our generation, Texas has taken no more important step to strengthen our health care delivery system than passing the 2003 medical liability reforms. The 2003 law swiftly ended an epidemic of lawsuit abuse, brought thousands of sorely needed new physicians to Texas, and encouraged the state’s shell-shocked physicians to return to caring for patients with high-risk diseases and injuries. As recently reported in The New York Times,[i]however, tort reform is a never-ending political and legislative maneuver in Texas. We cannot relax our guard against direct attacks on the 2003 law, attempts to weaken the Texas Medical Board, nor cynical schemes to turn Texans’ final days into lawsuit battlegrounds


[i] Ramsey, Ross. Fight Over Lawsuits Now Shapes State Politics. The Texas Tribune. March  2012 Available at. http://www.nytimes.com/2012/03/25/us/in-texas-trial-lawyers-and-a-pro-business-group-shape-politics-ross-ramsey.html. Accessed April 2012.

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How Americans Think About Screening Tests : NPR

How Americans Think About Screening Tests : NPR | Healthy Vision 2020 | Scoop.it

There are conflicting guidelines on when women should get mammograms and mounting questions on when the PSA blood test for prostate cancer is worthwhile. We asked how people are sorting things out.

 

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.

 

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Doctor Shortage May Swell to 130,000 With Cap on Residency Positions

Doctor Shortage May Swell to 130,000 With Cap on Residency Positions | Healthy Vision 2020 | Scoop.it

With a shortage of doctors in the U.S. already and millions of new patients set to gain coverage under President Barack Obama’s health-care overhaul, American medical schools are struggling to close the gap.

 

TMA supports:

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 GME 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.

 

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HHS Finalizes ICD-10 Deadline Delay to Oct. 1, 2014

In issuing the final rule, the Department of Health and Human Services postpones until Oct.

 

"The timing of the transition could not be worse, as many physicians already are spending significant time and resources implementing electronic health records in their practices, meeting meaningful use regulations, adapting to a host of new Medicare and Medicaid policies, and hurdling other administrative burdens created by the new health law," Dr. Speer said.

 

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Interactive: Healthy Food Scarcity

Interactive: Healthy Food Scarcity | Healthy Vision 2020 | Scoop.it

This map shows the percentage of food retailers that offer healthy options by census tract, as calculated by the Centers for Disease Control and Prevention in 2011. To give a sense of the poverty level in the area, the CDC’s data is combined with estimates from the American Community Survey to show how many households received benefits from the Supplemental Nutrition Assistance Program or were below the poverty line but did not receive SNAP benefits in 2010.

 

TMA supports increased funding for improved access to health foods.

 

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Détente in Scope-of-Practice Issue for Physicians, APRNs? « D Healthcare Daily

"The TMA and the Coalition for Nurses in Advanced Practice appear to have reached a détente in advance of the 2013 legislative session.

 

"Since 1989, Texas has had a site-based model for advanced practice registered nurses (APRN). More than 20 years created a polyglot of physician oversight regulations—some based on geographical distance, others based on care delivery, and still others based the number of APRNs. The inefficiency of current regulations for both nurses, who have been trained to prescribe independently, and physicians, who sometimes must travel to remote locations, is becoming more intolerable as the state faces increasing shortages of healthcare providers."

 

The increase in the number of specially trained health care professionals is good for Texans. TMA believes that a physician-led team approach to care, with each member of the health care team providing care based on his or her education and training, is key to ensuring that patients receive high-quality care. Maintaining the integrity of the health care team, under the physician’s overall direction, is good for patient care. TMA strongly supports physician-led teams utilizing a number of health care professionals, each bringing important skill sets and training to patient care. Team care requires cooperation and collaboration among all professionals, with a focus on quality, measureable outcomes, and efficient utilization of resources.

 

This growth, along with the narrow political interests of a small number of allied health professionals, has spurred calls for Texas to grant them more independent practice. Such an expansion in their scope of practice not only would exacerbate Texas’ physician shortage, it likely would increase costs and utilization, and could endanger the safety of our patients. The Texas Medical Practice Act was created more than 130 years ago to protect Texans from people who called themselves “doctor” but who did not have the skills, training, or education to warrant such a title. The act, administered by TMB, clearly defines the practice of medicine and the educational qualifications necessary to diagnose, independently prescribe, and direct patient care – and to be held accountable for that care.

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In U.S., Majority Overweight or Obese in All 50 States

In U.S., Majority Overweight or Obese in All 50 States | Healthy Vision 2020 | Scoop.it

A majority of American adults in all 50 states are either overweight or obese in 2012. West Virginia residents are the most likely to fall into one of these weight groups (69.3%), while Coloradans are least likely (55.1%).

 

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.

 

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Issue Brief: Analysis of Obesity Rates by State - Trust for America's Health

Issue Brief: Analysis of Obesity Rates by State - Trust for America's Health | Healthy Vision 2020 | Scoop.it

Report: Texas is one of 12 states with obesity rates of 30 percent or more.

 

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.

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Remove abortion advice 'gag order'

Remove abortion advice 'gag order' | Healthy Vision 2020 | Scoop.it

Talk about coming between patients and their doctors.

 

The ability of physicians to act in their patients’ best interests must not be compromised by outside – and sometimes competing – economic, political, and social pressures. Yet lawmakers and other nonphysicians progressively are inclined to delineate the details of the interaction between physicians and patients. Physicians will increasingly face nonphysicians’ attempts to mandate what tests, procedures, and treatments they must – or must not –provide to their patients. 

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ACP: Federal, state laws limit better care - Modern Physician

ACP: Federal, state laws limit better care - Modern Physician | Healthy Vision 2020 | Scoop.it

"A paper released by the American College of Physicians highlights state and  federal laws that it says limit physician-patient communication and present  roadblocks to better care."

 

The ability of physicians to act in their patients’ best interests must not be compromised by outside – and sometimes competing – economic, political, and social pressures. Yet lawmakers and other nonphysicians progressively are inclined to delineate the details of the interaction between physicians and patients. Physicians will increasingly face nonphysicians’ attempts to mandate what tests, procedures, and treatments they must – or must not –provide to their patients.

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Solo practice physicians: 'I'm not dead!' | Healthcare Finance News

Solo practice physicians: 'I'm not dead!' | Healthcare Finance News | Healthy Vision 2020 | Scoop.it

"The impending demise of solo physician practice has been predicted for several years now. In early July, recruitment firm Merritt Hawkins put the proverbial nail in the coffin of solo physician practice by declaring it officially dead. But like the old man in 1975’s “Monty Python and the Holy Grail” protesting “I’m not dead!”, doctors aren’t ready to be hauled off for burial."

 

The ability of physicians to act in their patients’ best interests must not be compromised by outside – and sometimes competing – economic, political, and social pressures. Yet lawmakers and other nonphysicians progressively are inclined to delineate the details of the interaction between physicians and patients. Physicians will increasingly face nonphysicians’ attempts to mandate what tests, procedures, and treatments they must – or must not –provide to their patients.

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Primary Care for the 21st Century: Ensuring a Quality, Physician-led Team for Every Patient -- Primary Care for the 21st Century: Ensuring a Quality, Physician-led Team for Every Patient -- America...

Primary Care for the 21st Century: Ensuring a Quality, Physician-led Team for Every Patient -- Primary Care for the 21st Century: Ensuring a Quality, Physician-led Team for Every Patient -- America... | Healthy Vision 2020 | Scoop.it

The United States can solve the primary care physician shortage by fully implementing physician-led patient-centered medical homes.

 

Texas has a fast-growing population and needs to work toward a 21st century health care workforce. More than ever, caring for larger panels of patients – particularly in primary care medical homes – will involve the skills of many different practitioners. Central to this concept is that these physician-led teams will utilize a number of health care professionals, each bringing important skill sets and training to patient care. Physicians will continue to provide patient care services, but they also will be called upon to manage the team’s care for larger populations, out of necessity and for essential coordination.

 

Team care will require cooperation and collaboration among all professionals, with a focus on quality, measureable outcomes, and efficient utilization of resources. It will be essential that the patient receive the right care, at the right time, by the right professional, in the right venue.

 

The physician is the highest-trained team member. It therefore falls to the physician – as both provider of care and manager of services delivered by others on the team – to supervise, implement science-driven and objective treatment protocols, coordinate the services of other professionals as well as medical specialists, and ultimately remain accountable for each patient’s care.

 

Integrating the talents of a diverse medical team under physician leadership will be one of the key challenges in the coming decade. Without physician direction, supervision, and management (or if the system evolves to accommodate teams led by practitioners with lesser training), medical care will trend toward even more fractured care, higher-than-necessary utilization, and creeping inefficiencies. This will lead to even higher costs, duplications of services, and lower-quality patient care. These inefficiencies in turn will hamper efforts to improve access to care.

 

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Outcome of 2012 Election Will Likely Affect Medicaid Far More Than Medicare

Outcome of 2012 Election Will Likely Affect Medicaid Far More Than Medicare | Healthy Vision 2020 | Scoop.it

The last month or so, the Presidential campaign has often felt like a war over Medicare. Republicans have claimed that the Democrats have robbed the trust fund to pay for a...

 

For decades, physicians have given away their services for free to patients who could not afford to pay. However, today’s health care market makes this very difficult. Medicare and Medicaid, which now cover 35 percent of health care in America,often pay physicians less than it costs them to provide their services. Commercial insurance companies’ payment rates, computed largely as a percentage of Medicare, have followed the government-run programs into the basement. The nation’s 50 million uninsured, including 6.2 million Texans, can rarely pay the costs of their health care. The squeeze leaves many physicians struggling to keep their practices open, let alone provide charity care. State and federal leaders must realize that cutting physicians’ payments is not an effective tool for controlling health care costs, and often exacerbates the cost of care. They also must realize that without physicians, no health care delivery system can be effective.

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The doctor won’t be seeing you now

The doctor won’t be seeing you now | Healthy Vision 2020 | Scoop.it

Next time you go for a checkup or medical procedure, bear in mind: There’s a good chance the person writing that prescription—or holding that scalpel—never went to medical school.

 

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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Colo. medical-home pilot seen to cut ER visits - Modern Physician

Colo. medical-home pilot seen to cut ER visits - Modern Physician | Healthy Vision 2020 | Scoop.it

It was a bumpy road, but leaders from Colorado's patient-centered medical home  pilot say the effort seems to have reduced emergency-department visits and  hopitalizations, especially among patients with chronic disease.

 

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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Healthcare Business Models Clash with Reforms

Healthcare Business Models Clash with Reforms | Healthy Vision 2020 | Scoop.it

While healthcare executives responding to a KPMG Healthcare survey say they expect major changes in the way healthcare is delivered and paid for in...

 

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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Artificial death extension: It means that I actually care

Instead of offering artificial life support to these patients, I will be offering artificial death extension.

 

Texas physicians abide by the Code of Medical Ethics, which includes “First, do no harm.” For this reason, TMA supports the Texas Advance Directives Act (TADA). Its aim is to allow patients to make their care preferences known before they need care, and to protect patients from discomfort, pain, and suffering due to excessive medical intervention in the dying process. The time may come when all that can be done for a patient is to alleviate pain and suffering, and preserve the patient’s dignity. For physicians, this is about medical ethics and providing medically appropriate care. 

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One in Five U.S. Adults Smoke, Tied for All-Time Low

One in Five U.S. Adults Smoke, Tied for All-Time Low | Healthy Vision 2020 | Scoop.it

Twenty percent of U.S. adults say they smoked a cigarette in the past week, tying the all-time low in Gallup trends since 1944. Recent declines in smoking are steepest among young adults, those aged 18 to 29, and those in the East.

 

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.

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Health-Care Reform and the 'Doctor Shortage'

Health-Care Reform and the 'Doctor Shortage' | Healthy Vision 2020 | Scoop.it

How many doctors are needed to serve the population, and what the impact of health care reform would be on that, are much debated but hard to measure, an economist writes

 

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. .

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Healthy Vision 2020 - The Basic Tenets

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A very short (30-second) video to remind you what Healthy Vision 2020 is all about. Read the whole document at http://www.texmed.org/healthyvision

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Texas tries to get between you, your doctor

Texas tries to get between you, your doctor | Healthy Vision 2020 | Scoop.it

In a recent letter to the state, the Texas Medical Association, joined by other medical groups, said Texas is about to embark on a plan for providing medical care to low-income women that will impose a “gag order” on discussing abortion even on...

 

The ability of physicians to act in their patients’ best interests must not be compromised by outside – and sometimes competing – economic, political, and social pressures. Yet lawmakers and other nonphysicians progressively are inclined to delineate the details of the interaction between physicians and patients. Physicians will increasingly face nonphysicians’ attempts to mandate what tests, procedures, and treatments they must – or must not –provide to their patients. 

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NQF endorses cancer, care-coordination, disparities measures | Modern Healthcare

NQF endorses cancer, care-coordination, disparities measures | Modern Healthcare | Healthy Vision 2020 | Scoop.it

NQF endorses cancer, care-coordination, disparities measures | Modern Healthcare...

 

In modern health care, evidence-based medicine (EBM) is good medicine.

 

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Six Main Reasons Physicians Are Dropping Medicare Patients

"September 1, 2012 is the current deadline for physicians who wish to opt out of Medicare —and record numbers are doing just that. According to a recent survey by the Texas Medical Association, the number of Texas physicians accepting Medicare patients dropped from 78 percent in 2000, to 58 percent in 2012. Texas is one of the few states that keeps Medicare opt-out information. HHS' Office of Inspector General (OIG) in January reported it couldn't pin down the extent of the problem nationally because Medicare and its contractors don't keep adequate data on physicians who opt out.

Why are so many physicians opting out of Medicare?"

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