Transforming physician practices TMA’s Physician Services Organization is a new TMA business that will help physicians do exactly that. The PSO will offer products and services to enable practices to improve their performance; streamline and improve administrative functions and technologies; and return physicians’ primary focus where it be- longs: patient care.
Many practices lack the organization
and infrastructure hospitals and payers already have to take on value-based care models. Dr. McCoy says that’s why TMA’s PSO will provide the missing link to help Texas physicians level the playing field and transform their practices to pursue new payment and delivery models. Whether practices choose to do that independently, as part of a large group, or through clinical integration of mul- tiple independent practices, the PSO has identified four categories of products and services to meet practices’ varying goals and levels of sophistication. They are:
• Practice transformation: tools and services to strengthen practice vi- ability and prepare practices for new payment models, including optimiz- ing staff workflow, strengthening bill- ing and collections processes, and making use of new technologies to improve patient care and compliance.
• Clinical integration: services and technologies for physician network development, network administration, and contracting that provide adminis- trative support to existing physician networks and help for independent practices that want to collaborate for contracting and managing population health.
• Value-based care models: technology, strategies, and staffing to help prac- tices secure value-based contracts or meet requirements for incentive pay- ments, including case management; care management; population, qual- ity and utilization analytics; and pa- tient engagement.
• Enterprise solutions for physician networks and groups, including pay- er functions for those that negotiate direct contracts with employers and
other payers, and technologies that enable health information exchange among the health community.
Dr. McCoy describes entities like
ACOs, patient-centered medical homes, health care collaboratives, and indepen- dent practice associations as vehicles
that allow doctors to drive health care change, participate in new payment methodologies, and take better care of a population. TMA is not creating the actual vehicle, like an ACO. “TMA is cre- ating the tools and the culture sets that empower those vehicles. The PSO is re- ally the engine.”
How your PSO can help you
Regardless of your practice style, TMA’s Physician Services Organization (PSO) will be able to help you prepare for the ac- countable and value-based care payment and delivery models that are quickly becoming a fixture in today’s health care market.
If this is you, TMA’s PSO can help:
• You know some of your practice’s costs are too high, but you’re not sure which ones or how to best control them.
• You’re working 15-hour days, seeing more patients than ever but making less than you made 20 years ago, and you can’t figure out why.
• You’re a new member of an accountable care organization and don’t understand how to use the care management nurses assigned to your practice.
• You’ve just received your first clinical outcomes spreadsheet for your Medicare patients and don’t know what it means to you or your patients or to your bottom line.
• Twenty-five physicians in your community want to create a clinically integrated network, and you want to know what that entails and whether you should join.
• You’re part of a clinically integrated network, on the hook to drive efficiencies in patient care, and you need to know how to use the network’s data to manage referrals appropriately.
• Your community is struggling to develop a clinically integrat- ed network, but there is no consensus on how to proceed and no strong physician leadership.
The PSO is still being developed and expected to launch early this year.
January 2014 TEXAS MEDICINE 25
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