Ad Directory
Alfredo L. Viteri, MD, PA ..........................51 Athenahealth ................................................6 Avita Specialty Pharmacy ..................... 64 Brown McCarroll .........................................31 Capital Farm Credit ..................................45 CompHealth .................................................51 Covenant Medical Group .......................... 7 DSHS HIV/STD Program ..........................31 Frost Bank .....................................................14 Humana .......................................................IBC International Business Exchange ........38 Kindred ............................................................8 Leichter Law................................................37 Lonestar Smiles..........................................56 nVenio Analytics ....................................... 50 REC - West Texas .......................................18 Rose Walker LLP ......................................... 5 Rx Security ................................................. 64 Shannon’s Hope Foundation ................43 Texas Academy of Physician Assistants ................................................40
Texas Medical Association Bank of America ....................................63 ICD-10 Webinar .....................................40 Membership ..............................................19 Practice Consulting ................................. 3 PSO .............................................................39 TEXPAC .....................................................57
Texas Medical Association Insurance Trust ...........................................................BC
Texas Medical Liability Trust ........IFC, 32 Texas Mutual Insurance Co. ...................36 Transfirst .......................................................35 West, Webb, Allbritton and Gentry, PC ............................................... 46 Westat ...........................................................38
Is BTE right for me? Because many primary care practices are cash-strapped these days, however, TMA’s Council on Health Care Quality developed a suite of tools to help prac- tices evaluate their return on investment in BTE before jumping in. The tools and instructional videos are available at
www.texmed.org/ClinicalQualityTools/. The first step to BTE participation in- volves applying for recognition, which does take time and money. TMA’s BTE Eligibility Tool takes physicians through a series of steps to determine which pa- tients will meet BTE eligibility require- ments, which vary by condition. As pa- tient information is entered — such as relevant diagnosis and dates of the visit and diagnosis — the calculator will au- tomatically determine patient eligibil- ity and notify physicians when they’ve reached the required number of eligible patients.
Once physicians earn BTE recognition,
they are eligible for payer incentives. Again, to collect those payments, doctors must do some homework in gathering quality data on that plan’s eligible ben- eficiaries and submitting it for approval. TMA’s BTE Return on Investment Tool calculates the potential incentive dollars available after inputting the number of BTE-eligible patients (you must contact the health plan for this information) and any costs associated with BTE reporting, such as staff time to gather patient data or fees to apply for BTE recognition. Drs. Ehrlich and Fuller say the eligi-
bility process definitely required some homework to pull the necessary data, although using their EMR systems to upload the information was relatively easy. Dr. Fuller says his reporting to pay- ers takes roughly five minutes per chart using an EMR.
Advertise for as little as $25! TMA’s website experiences nearly 320,000 visitor sessions each month. With this kind of activity, can you afford not to advertise in TMA’s online classifieds? Place and purchase your classified ad now at
http://classifieds.texmed.org.
The TMA/HCMS test pilot revealed that while some BTE-eligible practices had to adjust their operations and pa- tient flow, most had a return on invest- ment. Although paper-based practices had a tougher time adjusting, some still benefitted.
TMA will continue to monitor pay- ers’ use of the program to make sure the quality information is used only to in- centivize, not punish, physicians, Dr. Eh-
62 TEXAS MEDICINE September 2013
rlich says, adding that so far, there has been no evidence of such misuse. The Council on Health Care Quality also is looking at ways to help practices sim- plify and streamline the data collection for reporting.
One way to do that would be to get other major payers on board, she says, adding that so far the BTE program is less labor-intensive than Medicare’s qual- ity reporting programs in which physi- cians are not seeing similar financial rewards.
Because BTE recognition overlaps
NCQA recognition, doctors also would like to see the timelines for the two pro- grams aligned, Dr. Fuller added. BTE recognition is renewed every two years; NCQA, every three. To help lower reporting burdens on physicians, BTE leader Ms. DiLorenzo says her organization has projects un- der way, such as cloud-based platforms, aimed at aligning clinical quality mea- sures in BTE with other reporting pro- grams such as Medicare’s PQRS and Electronic Health Record Incentive Pro- gram, as well as maintenance-of-certifi- cation programs.
AMA, Joint Commission release new guidelines to reduce overuse
In the latest effort to curb unnecessary medical treatments, the American Medi- cal Association and The Joint Commis- sion jointly released recommended strat- egies to reduce five commonly overused interventions, such as the use of antibi- otics for viral upper respiratory infec- tions and early-term elective deliveries. The list comes on the heels of a simi- lar campaign by the ABIM Foundation known as “Choosing Wisely.” The pro- gram encourages physicians and pa- tients to discuss the appropriateness of medical tests and procedures that may be unnecessary or even harmful. The Texas Medical Association recently won a $50,000 grant to advance the Choos-
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