Blogged Arteries

Want to improve health care in America? Want to be a catalyst for change? Want to help elect politicians who will put patients and physicians first? Participate in the upcoming TEXPAC Alliance Volunteer Days.

Several provisions of the new health system reform law take effect Sept. 23.

TMA’s Be Wise — Immunize^SM program is launching a new initiative to encourage health care workers to get immunized against the flu.

Tort reforms that TMA and its allies worked so hard to achieve in 2003 continue to pay off for physicians as the Texas Medical Liability Trust (TMLT) cut liability insurance premiums by 1 percent, effective Jan. 1, and announced a 24–percent dividend for renewing TMLT policyholders.

The health system reform law establishes a new breed of health care delivery system called accountable care organizations (ACO). Be wary and be informed. TMA strongly suggests that you take the time to learn about these systems, and understand their differences and what they could mean to your practice and your patients, before you sign any agreements.

If you're confused about the new health system reform law and its many new provisions, you're not alone. That's why the Texas Medical Association will host its second Tele-Health Reform School next month.

TMA won another round in its ongoing effort to protect the safety of patients in mid-August when an Austin district judge said he intends to limit chiropractors' right to diagnose medical conditions.

The U.S. Food and Drug Administration (FDA) is warning physicians not to use unapproved intrauterine devices (IUD) and intrauterine systems (IUS) or face the possibility of going to jail.

Physicians interested in the 2010 Physician Quality Reporting Initiative (PQRI) and Electronic Prescribing Incentive (eRx) programs can ask questions and learn how to join during a conference call from 2 to 3 pm CDT on Tuesday, Aug. 17.

Texas will gain about $850 million in federal money for Medicaid, thanks to congressional approval of legislation extending enhanced matching federal Medicaid payments through mid-2011. The U.S. House of Representatives joined the Senate in approving the bill Aug. 10.

It's final. The Texas State Board of Podiatric Medical Examiners cannot go beyond its statutory authority and the will of the Texas Legislature.

The TMA Patient Safety and Medical Errors continuing medical education (CME) course has been revised and reposted on the TMA website.

CIGNA says it will soon make public the results of its annual evaluation of physician quality and cost efficiency. Almost 20,000 physicians in Houston, Dallas-Fort Worth, San Antonio, and Austin will be rated.

A new law requires pain management clinics to be certified by the Texas Medical Board (TMB). The Texas Medical Association supported Senate Bill 911, which directs TMB to adopt rules to ensure quality of patient care and to set personnel requirements at pain management clinics. The new law also gives TMB authority to inspect pain management clinics, or entities believed to be pain management clinics, to determine whether they're operating legally.

With nearly 70 Texas hospitals with some type of physician investment, the state is a national leader in the physician-owned hospital industry. And, members of that industry say it has been good for patients. But the health system reform law Congress passed earlier this year slams the door on new physician-owned hospitals by prohibiting them from obtaining a Medicare provider number.

From August's Texas Medicine.

An increasing number of medical graduates in the country, particularly in Texas, are finding it hard to match to a residency program in their preferred specialty. While medical educators say there are various reasons for that, almost all point to a growing imbalance in the ratio of medical graduates to residency slots. That imbalance is particularly apparent in Texas, where the state offered fewer first-year residency positions in 2010 than it had medical graduates.

From August's Texas Medicine.

Physicians hoped the health system reform law would eliminate the Sustainable Growth Rate (SGR) formula that drives down Medicare fees. The SGR, however, remains in place, and the law created a new board, the Independent Payment Advisory Board (IPAB), with the authority to cut fees even further, possibly on top of cuts under the SGR.

From August's Texas Medicine.

State law should require insurance companies and pharmacy benefit managers (PBMs) to post accurate and complete drug formularies online that physicians can access when prescribing medications for patients, the Texas Department of Insurance (TDI) recommends in a report to state officials and legislative leaders.

An American Medical Association survey shows an average of 95 medical liability claims filed for every 100 physicians in the U.S. That's almost one per physician and demonstrates the need for the rest of the country to adopt liability reform like Texas did.

After I received some comments and questions on a previous post showing the uninsurance rate for all 254 Texas counties, I decided to dive just a little deeper into the data. Here are the rankings for the 20 most populous counties, first for everyone under age 65 and then for children (under age 19.) Recall that the under-65 statewide rate is 26.8% in this 2007 data. For children under age 19, it's 19.5%.

Note that Webb, Cameron, El Paso, and Hidalgo counties -- all poor counties along the border -- lead the list for people under 65. But four of the five move down the list for people under 19. The top five there are Dallas, Webb, Tarrant, Harris, and Montgomery.

Texas 20 Most Populous Counties, Uninsured Rate for People Under 65

• Harris County: 31.3%
• Dallas County: 30.8%
• Tarrant County: 26.0%
• Bexar County: 22.8%
• Travis County: 25.0%

• Collin County: 16.6%
• El Paso County: 33.0%
• Hidalgo County: 31.5%
• Denton County: 19.9%
• Fort Bend County: 22.8%

• Montgomery County: 25.1%
• Williamson County: 18.7%
• Cameron County: 33.7%
• Nueces County: 22.8%
• Brazoria County: 25.3%

• Galveston County: 21.5%
• Bell County: 20.4%
• Lubbock County: 26.4%
• Webb County: 38.7%
• Jefferson County: 22.7%

Texas 20 Most Populous Counties, Uninsured Rate for People Under 19

• Harris County: 21.9%
• Dallas County: 25.5%
• Tarrant County: 22.7%
• Bexar County: 16.2%
• Travis County: 17.4%

• Collin County: 10.3%
• El Paso County: 19.9%
• Hidalgo County: 17.4%
• Denton County: 17.5%
• Fort Bend County: 19.5%

• Montgomery County: 20.9%
• Williamson County: 16.4%
• Cameron County: 19.2%
• Nueces County: 13.8%
• Brazoria County: 19.9%

• Galveston County: 15.4%
• Bell County: 13.0%
• Lubbock County: 15.9%
• Webb County: 25.4%
• Jefferson County: 13.5%