My Weblog

Increasing the value of Primary Care?

The General Accounting Office recently testified before the US Senate Committee on Health, Education, Labor, and Pensions on the need to increase the value of Primary Care Professionals.  I haven't seen a report that lays out the problem of undervaluing primary care more clearly.  Read it at:

http://www.gao.gov/new.items/d08472t.pdf

Texas Medicare Manifesto

The battle to fix the broken Medicare system rages on.  The Texas Medical Association recently launched a new campaign called the Texas Medicare Manifesto to educate leaders and patients on what's needed to fix Medicare.  The Manifesto's key points include: 1) Fix the formula; 2) Put patients before insurance companies; and 3) Tear down the silos ( or balance the payment system between Parts A, B, C and D).

Check it out:  http://www.texmed.org/Template.aspx?id=6496

In December, Congress gave physicians a small Medicare increase and extended the program for six months, which means it will all come to head in June 2008.  Get ready, this is going to be a real fight.

Presidential Politics and Healthcare

This Modern Physician breaking news just came across my email:

The nation's second-largest physician organization, the American College of Physicians, has called on the presidential candidates of both parties to pledge to support policies that it says will help make the U.S. healthcare system second to none by expanding the use of health information technology, enhancing primary care and making affordable health coverage available to all.

Lt. Governor Releases Interim Study Charges

Lt. Gov. David Dewhurst released the much anticipated Senate Interim Study Charges late yesterday afternoon.  And it's a lot of charges, which means the Senate Committees will be busy. The following are some important charges which TAIMS will be following:

Health & Human Services:  Study the state's current and long-range need for physicians, dentists, nurses, and other allied health and long-term professionals.  Make recommendations on how the state can help recruit high-need professions, especially for primary care providers and long-term care professionals in the underserved regions of Texas.  (Joint charge with the International Relations and Trade Committee)

State Affairs:  Study and make recommendations for reducing the number of uninsured Texans, focusing on the following:  Options to increase access to private health insurance, including 3 share programs, employer sponsored plans and individual insurance; Options to reduce health care premiums, including creation of special plans with increased deductibles and catastrophic coverage; and Analysis of state and federal regulations that contribute to higher premium costs.

And They're Off: House Public Health Committee to Hold Interim Meeting

It didn't take the House Public Health Committee long to schedule their first interim hearing.  The committee with meet on Thursday, January 17, 2008, and will focus on wellness and prevention issues.  The committee will evaluate the wellness intiatives undertaken by the State such as the newly created state employee wellness and prevention legislation.  It will study the potential health benefits and optimizing the return on the State's investment on wellness.  TAIMS will provide an update on developments.

TAIM Leaders attend TEXPAC Specialty Society Retreat in San Antonio

Dr. Gene Stokes, Dr. Rene Rodriguez, and Dr. Scott Yates represented TAIMS at the 2008 TEXPAC Specialty Society Strategic Planning Forum in San Antonio, Texas over the weekend.   Each member participated in at least two issue breakout sessions in order to provide input on concerns relating to internal medicine.  Most notably, Dr. Rodriguez provided an update on TAIMS key concerns during the Saturday afternoon specialty society panel discussion.  Dr. Rodriguez stressed the most important issue to TAIMS is finding a real solution for improving Medicare payment.

January 2nd is Legislative Candidate Filing Deadline

Anyone hoping to run for the Texas Legislature for 2009 must officially file paperwork by 6pm today, January 2, 2008, at their respective party headquarters.  The Texas Primary Election is March 4, 2008, and the General Election is November 4, 2008.  The 2008 Campaign season starts in earnest once the filing deadline has past.

House District 97 Special Election

Yesterday in Forth Worth, Pediatrician Mark Shelton narrowly lost the special election run-off for the Texas House District 97.  It was much closer than anticipated due to low voter turnout, and a run-off for an overlapping city council seat pitting tow candidate who enjoyed the support of many of the Democratic interests in Fort Worth.

The Tarrant County physician and alliance community was indespensible and an integral part of Mark's success throughout the campaign.

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End of Year Medicare Dance Continues...........

Thank you to the many TAIMS Key Contacts who called Senators Hutchinson and Cornyn on Tuesday and Wednesday to push for a two-year physician payment update and stop the Senate’s leaning toward paying for a payment freeze or a small update for 2008 by increasing the scheduled cut the following year.

The Senate Finance Committee, decided on Wednesday evening, December 5 to cancel its scheduled “mark-up” (taking action on) of legislation in committee. Senate Finance is now beginning direct negotiations with the House.

The House’s position in negotiations will start from H.R. 3162 (passed by the House this year), which contained a number of changes to Medicare, including a positive physician payment update of 0.5 percent for 2008 and again in 2009, averting the 10.1 percent payment cut scheduled for January 2008 and an estimated 5 percent cut in 2009.    Although House and Senate leaders have said they want to stop the 10.1 percent cut, time is running out. There is a growing risk that they will not reach agreement on how to pay for it in time to stop the cut from going into effect.

House Legislative Interim Studies Announced

This week, Speaker Craddick released interim study topics for the House committees. TAIMS identified the following as the most relevant to internal medicine.  You will receive updates as the studies progress and hearings are set next year.

House Committee on Appropriations
Comprehensively review Medicaid provider reimbursement rate methodologies, including the impact of factors such as infrastructure concerns, federal minimum wage changes, and cost reports.  The review should also address health care concerns such as access to care, quality of care and value.  Any recommendations should take into account current rate increases impacting the next fiscal year.

House Committee on Public Health

1.     Monitor and evaluate the full array of wellness initiatives undertaken by the State of Texas to include the newly adopted state employee wellness and prevention legislation (HB 1297, 80^th Legislature, Regular Session) and a pilot program to encourage healthy lifestyles, such as smoking cessation within the Medicaid program (SB 10, 80^th Legislature, Regular Session) and for state employees.  Develop strategies for maximizing potential health benefits and optimizing the return on the State of Texas’ investments in wellness.  Include a review of other state and private sector programs for employee wellness that result in prevention cost savings

2.     Research issues relating to the Indigent Health Care and Treatment Act (Chapter 61, Health and Safety Code) and related local health care initiatives (Chapter 534, Government Code), and make recommendations to address any imbalance between counties for the provision of health care

3.     Review issues related to federal changes for tamper-resistant prescription pad requirements, and monitor the activity of the Texas Department of Public Safety Controlled Substances Advisory Committee in response to SB 1879, 80^th Legislature, Regular Session.

House Committee on Insurance
1.     Examine states that have made the transition from heavily regulated health insurance markets to less regulated markets in order to assess the impact on market competitiveness, prices, consumer satisfaction, and regulatory costs in those states.  Specifically, identify current barriers and possible enhancements to flexibility in purchasing health insurance, including the purchase of health insurance plans offered in other states.  Review and evaluate state law and agency rules related to the use of health savings accounts and health reimbursement arrangements, particularly by small businesses.  Review possible tax incentives for purchasing private insurance.

2. Study and make recommendations regarding the feasibility of establishing a “health insurance exchange” in Texas.