TMA PRACTICEEDGE PROVIDES REAL OPTIONS TO DESIGN YOUR OWN FUTURE In February, TMA announced the launch of TMA PracticeEdge, a new services company developed by TMA to bring physicians the technologies and expertise that are essential to providing — and proving — qual- ity care, including accountable care services and prac- tice transformation services. Interested in
learning more about TMA PracticeEdge? Visit
www.TMA PracticeEdge .com, or contact us at info@TMA
PracticeEdge.com or (888) 900-0334. Read more in
this issue (see “TMA PracticeEdge Gives Texas Physicians Real Options to Design Their Own Future,” page 17), and watch for additional detailed coverage in the May issue of Texas Medicine.
tools to help physicians cope and adapt to the fast-approaching world of value-based care. (See “Your Value-Based Care Toolbox,” page 28–30.) In section 6, “Use Health Information
Technology Wisely,” of Healthy Vision 2020, Second Edition, TMA leaders write: “HIT needs significant work to make it more ef- ficient and effective for patient care. Many physicians find they are clicking more but achieving less. Currently, it’s too expensive, too disruptive to patient care.” The document calls for fixes to MU, sim- plification of Medicare quality reporting systems, significant risk-adjustment of VBM scores, and support for physician-driven quality improvement initiatives. (Read more at
www.texmed.org/healthyvision.) To address some of the imminent threats, AMA’s letter proposes fixes that:
• Require physicians to meet only one set of quality reporting requirements for PQRS, MU, and VBM, and provide timely feedback on their reporting;
• Create a more robust set of quality re- porting options and a formal appeals process for PQRS;
• Offer a more flexible approach for meet- ing MU requirements; and
• Repeal or at least tamp down the VBM penalty structure and allow for a longer, more flexible phase-in period.
TMA Director of Health Information
Technology Shannon Vogel says Medicare responded in part by allowing physicians to combine the clinical quality measures they must report under MU with PQRS report- ing. She recommends physicians “check with their vendor to see which [measures] can be submitted to CMS electronically. Vendors typically do not certify for all clini- cal quality measures reporting.” At medicine’s urging, Medicare also for
the first time made the QRURs available for all physicians last fall. NQF also took up medicine’s call for
some form of socioeconomic risk adjust- ment in quality measurement after the board approved a trial to assess the impact of factors like income, education, race, and ethnicity on the process. Dr. Walters and Mr. Miller — members of an NQF advisory com-
34 TEXAS MEDICINE April 2015
mittee and its board, respectively — agree the development signals potential improve- ments to the current system, as CMS often takes its cues from NQF. Also thanks to TMA’s and AMA’s advo-
cacy efforts, the unprecedented progress Congress made last year drafting a bill to eliminate the flawed Medicare Sustain- able Growth Rate (SGR) formula included a more streamlined quality reporting-based system. The proposed Merit-Based Incen- tive Payment System, or MIPS, would still link a portion of doctors’ pay to their qual- ity performance, but it consolidates PQRS, MU, and VBM. That change could help re- duce physicians’ compliance costs and offer fewer penalties and more flexibility. Penal- ties under the current programs would still exist, but eventually sunset in 2018 and be replaced by a new set of penalties and in- centives, Ms. Kinney says. TMA is fighting to keep SGR repeal ef-
forts alive, with help from key congressio- nal members, including vice chair of the House Energy and Commerce Subcommit- tee on Health and bill sponsor Rep. Michael C. Burgess, MD (R-Lewisville), and House Ways and Means Health Subcommittee Chair Rep. Kevin Brady (R-The Woodlands). Should SGR repeal efforts stall yet again, TMA is working with these congressmen and other members of the Texas delegation to simplify the value-based care programs. Mr. Miller says thus far, Medicare has
done little to truly reform care, but physi- cians can play a pivotal role. “If somehow we are going to be paying the exact same way for the exact same thing, and throw a few quality and efficiency measures on top, that’s not what I call value-based care,” he said. Congress has been looking at how to cut elsewhere to pay for SGR versus “how can we redesign the Medicare system. That’s not been the conversation in Wash- ington. Who can do that? Physicians can do that.” n
Amy Lynn Sorrel is associate editor of Texas Medicine. You can reach her by phone at (800) 880-1300, ext. 1392, or (512) 370-1392; by fax at (512) 370-1629; or by email at
amy.sorrel@
texmed.org.
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