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TMA House of Delegates backs ACO patient, physician safeguards


Accountable care organizations (ACOs), the cost of preauthorization, talking and texting while driving, and “fracking” were among the many issues addressed by the Texas Medical Association House of Delegates May 14 during TexMed 2011 in Houston. The house dealt with more than 70 resolutions on economic, public health, sci- ence, and education issues. Delegates adopted a recommendation from the Ad Hoc Committee on Account-


able Care Organizations after the committee analyzed new ACO models and devel- oped principles and guidelines for TMA. The committee recommended and the house agreed that these safeguards should be in any ACO:


• State regulation, • Voluntary physician and patient participation, • No marketplace-limiting agreements, • Due process, • Physician supervision of economic and quality measures, • Physician flexibility in patient referral and antitrust laws, • Patient-focused Medicare ACOs, • Patient-focused Medicaid ACO spending benchmarks, • Patient-focused state ACO pilot initiatives, • Alignment of financial incentives for good patient care, and • Health information technology.


Loosely defined, an ACO is a collaboration of health care professionals who accept


responsibility for the costs, quality, and effectiveness of care delivered to a defined patient population. The Centers for Medicare & Medicaid Services will launch the ACO model as a voluntary program no later than January 2012. And though ACO regulations have not been finalized, many hospitals and physicians are rushing to form collaborations — worried they’ll be locked out of the market as ACOs expand beyond Medicare. TMA will conduct a free webinar update when the regulations are finalized. In addition, the Physicians Foundation is developing a toolkit for physicians that


will include organizational documents for starting an ACO. TMA will make it avail- able to members.


Among their other actions, delegates voted to:


• Support policy that insurers must compensate physicians for the cost of seeking preauthorization for medica- tions, studies, or procedures;


• “Take a firm stand against the epi- demic use” of cell phones and texting while driving because they often lead to accidents;


• Support legislation that will allow physicians to dispense and charge for pharmaceuticals, other than Schedule I-V controlled substances;


• Ask the legislature to encourage natu- ral gas production but protect Texas water from the risk of hydrofracking to increase gas production by requir- ing disclosure of “fracking” fluid com- ponents;


• Reject term limits for AMA delegates alternate delegates;


• Work to streamline Medicaid HMO paperwork;


• Reject a request that TMA call for ending federal Medicare and Medic- aid and allowing states to continue the systems without any federal rules;


• Urge legislators to reinstate rules al- lowing physicians working for the Texas Department of Aging and Dis- ability Services to qualify for state education loan repayment programs; and


• Reject a proposal that TMA support a ban on teenage fathers from par- ticipating in extracurricular activities unless they pay child support.


In other action, the House of Dele-


gates elected new officers for the coming year. House Speaker Stephen Brotherton, MD, Fort Worth; Vice Speaker Clifford Moy, MD, Austin; and Secretary/Trea-


July 2011 TEXAS MEDICINE 9


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