Stories with related Professional Interests

Quality of Life: Pay-for-Quality Programs Increasingly Address Nonmedical Drivers of Health - 03/15/2024

Insurance payers seldom give physicians incentives to address nonmedical drivers of health, especially in traditional fee-for-service payer contracts. Those incentives remain rare even in pay-for-quality programs that emphasize value-based care, but they are gaining traction.

Blue Cross Says MOC Not Needed for BlueCompare - 02/28/2024

Physicians across the state reacted strongly to a March 5 letter from Blue Cross and Blue Shield of Texas (BCSTX) that implied the state’s largest insurance company is now using maintenance of certification (MOC) to rate physicians. That was not the intent, the company’s president says.

Mastering Quality Reporting: Ease the Challenge of Quality Reporting - 07/10/2023

Understanding the maze of quality reporting pathways may help ease the challenge.

Driving the Quality Train: TMA Physicians Lead the Way, From Measures to Standardization - 07/10/2023

In a proactive effort to resolve physician complaints, TMA and its members are deeply involved in quality issues, from participating in the development of new measures to pushing payers for standardized quality programs and supporting physicians who are curious about value-based care.

TMF Offers Resources to Navigate CMS Requirements - 05/16/2023

TMF has launched three physician-focused networks designed to save time, improve patient care, and reduce costs associated with meeting these requirements. These programs, focused on immunizations, behavioral health and value-based improvements, are designed to help physicians benefit from—and not be penalized by—these mandates.

Going Nowhere: APM Committee Resignations Cast Doubt on Payment Models' Future - 05/10/2023

Resignations from HHS advisory committee cast doubt on future of physician-created alternative payment models.

The Power of Data: UTHealth Publishes Claims Statistics - 06/29/2022

After three years of work, the Center for Healthcare Data at McGovern Medical School at UTHealth is sharing part of its growing trove of numbers for data-driven discussions on many aspects of health care in Texas. The center doesn’t have all the answers. But its work under a federal certification from the Centers for Medicare & Medicaid Services (CMS) has resulted in valuable state and regional statistics that the center leaders believe provide food not only for thought, but also for policy.

MIPS 2021 Data Submission Now Open - 04/05/2022

Participants in the 2021 performance year of the Quality Payment Program’s (QPP’s) Merit-Based Incentive Payment System (MIPS) can now submit their data through the QPP website. You can submit and update your MIPS data until 7 pm CT on March 31.

TMA Supports New Quality Measures for Social Determinant Screening - 03/10/2022

Showing its continued commitment to highlighting and addressing social determinants of health, the Texas Medical Association offered its “strongest support” to a pair of new quality measures the National Quality Forum (NQF) is considering for screening of those social factors.

Medicare Eliminates Cost Category Factor in 2020 MIPS - 06/01/2021

Medicare is continuing to acknowledge recent extraordinary events in granting physicians relief from its Merit-Based Incentive Payment System (MIPS).

The Customer Is Always Right? Patient-Reported Outcome Measures Have Fans and Detractors - 01/26/2021

For too long, some doctors say measures of a physician’s quality of care have been about process: the average length of a patient stay, for example, or a patient’s readmission rate. The bottom line is results, and that’s why a shift to patient-reported outcome (PRO) measures is necessary. However, even proponents of PRO measures note that collecting the information from patients for those metrics places burdens on physicians, and some remain skeptical of bonuses and penalties tied to a measure that derives from a subjective factor: what patients think.

Troubling Trend: Texas’ 2018 QPP Data Contains More Bad Signs - 01/05/2021

As the Centers for Medicare & Medicaid Services continues to churn out glowing data annually on its Quality Payment Program (QPP), a full picture of the program’s impact eludes the agency’s reporting. According to the Texas Medical Association’s analysis of state-level data in the 2018 QPP Experience Report, it’s clear that small practices continue to feel most of the program’s punitive pressures.

Seeking a Measure of Reason: TMA Joins Collaborative to Standardize Quality Metrics - 03/31/2020

TMA joins collaborative seeking to identify and standardize quality metrics.

Supporting Fair APM Payments: AMA Backs Accounting for Social Determinants of Health - 01/02/2020

Alternative payment models (APMs) are considered a key part of the future of value-based care. But for them to be successful, the American Medical Association says, APMs need to be fair, which means adjusting for the circumstances that make physicians’ cost and care challenges unique.

Quality Care Pilot Takes Flight - 09/03/2019

How one children's clinic uses a targeted program to dramatically improve care, lower costs.

Faulty Guidelines - 06/03/2019

Former Texas Medical Association President Josie Williams, MD, was tenacious in advocating that organized medicine pay zealous attention to two topics: data and guidelines. In this, she was both sage and prescient. We have done well in following her recommendations on data, but we continue to fall far short of where we need to be on guidelines.

Tips on How to Report Data on Quality Measures for MACRA - 04/19/2018

Tips from TMA to help you determine which reporting mechanism will best fit your practice for the first Merit-Based Incentive Payment System (MIPS) performance period in 2017.