Reduce Your Costs and Workplace Injuries.
It’s the Prescription for Great Savings.
Te Texas Medical Group combines your business with other health care businesses to provide workers’ comp premium discounts and job-specific safety resources. As a member of the Texas Medical Group Safety Group, eligible businesses may also qualify for both group and individual dividends and receive a discount for choosing the health care network option.
for evaluating and rewarding quality care “is much needed,” he wrote to con- gressional leaders in a June letter. But those measures must be evidence-based and developed with clinical input from practicing physicians. “If there are quality deficits that we know need to be fixed, that care will be cheaper when they get fixed, and we can all agree it’s a good idea, those are prob- ably reasonable [quality measures] that we could include” in a new Medicare payment system, Dr. Brotherton told Tex- as Medicine. “But at this point, nobody has come up with the Golden Fleece.” As an example, the Fort Worth ortho- pedic surgeon pointed to the nationally developed Surgical Care Improvement Project (SCIP) measures, which recom- mend hospitals use certain pre- and postsurgery checklists to help avoid infections, complications, and the like, and hopefully reduce costs. In fact, the measures in some cases have had the op- posite effect, Dr. Brotherton says. “Those are quality measures put out with a mandate: Follow these or your [hospital] payment is going to drop. And we found out that when we did that, it didn’t make things better; it made things worse. There were more complications, and they were more expensive. If you follow all of the recommendations for antibiotic use, for instance, the infection rate does not go down; and if you follow the DVT [deep vein thrombosis] recom- mendations, infection rates can go up.” Physicians should not be financially
responsible for systems that are untested or don’t work, he says. Nor should they be punished for factors beyond their control, TMA’s letter states. For example, any new performance-based payment system also must properly adjust for risk factors, such as patients’ socioeconomic status and education level, and patient responsibility factors, such as decisions to forego care.
Contact your agent or Diannah Tatum at (806) 792-5564 or email
info@tmgworkcomp.com.
36 TEXAS MEDICINE September 2013
Visit us at
www.texasmedicalgroupwcprogram.com. Dividends are based on performance and are not guaranteed.
In a July 22 hearing to review the House Energy and Commerce proposal, Health Subcommittee member U.S. Rep. Eliot L. Engel (D-N.Y.) expressed similar concerns, saying proper risk adjustment should account for socioeconomic chal- lenges associated with providing good health care “to help ensure an adequate
©2013 Texas Mutual Insurance Company
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