Related Stories

CMS Finalizes 2025 Medicare Advantage Payment Rates - 04/16/2024

Despite a 0.16% reduction in base pay rate, Medicare Advantage plans are projected to see a 3.7% growth in revenue in 2025 thanks to a rising average patient risk score.

CMS to Debut Primary Care Payment Model - 04/10/2024

In an effort to address financial barriers to accountable care organizations’ provision of primary care services, Medicare will test a new value-based payment model for approximately 130 starting in 2025 and running through 2029.

Medicare Advantage – and Disadvantage: Program Enrollment Grows Amid Physician Concerns - 04/03/2024

Despite its growing popularity among Medicare patients, Medicare Advantage is divisive among physicians.

Cyberattack Prompts CMS to Extend 2023 MIPS Flexibilities - 03/19/2024

The Centers for Medicare & Medicaid Services recently announced two flexibilities related to Medicare’s Merit-Based Incentive Payment System 2023 performance year, citing the recent cyberattack on Change Healthcare and heeding advocacy by organized medicine.

Quality of Life: Pay-for-Quality Programs Increasingly Address Nonmedical Drivers of Health - 03/15/2024

Insurance payers seldom give physicians incentives to address nonmedical drivers of health, especially in traditional fee-for-service payer contracts. Those incentives remain rare even in pay-for-quality programs that emphasize value-based care, but they are gaining traction.

Middle Ground: Medicare Offers Options Amid Shift to Value-Based Care - 03/05/2024

Physicians are divided on the issue of value-based care, but, with Medicare forging ahead, the Texas Medical Association is focused on monitoring the development of alternative payment models, educating members about their options, and advocating for physician protections.

Survey: APM Participation Grows, But Fee-For-Service Still Dominates - 01/24/2024

Physicians increasingly report participating in an accountable care organization or other alternative payment model, but fee-for-service payments still make up the bulk of practice revenue, continuing a yearslong trend.

Reminder: Apply for 2023 MIPS Hardship Exemption by Jan. 2 - 11/28/2023

Physicians eligible to participate in Medicare’s Merit-Based Incentive Payment System may be spared a steep financial penalty, continuing a trend seen throughout the COVID-19 pandemic.

Feds Propose Information-Blocking ‘Disincentives’ - 11/14/2023

The U.S. Department of Health and Human Services released a proposed rule that would establish what it is calling “disincentives” that could amount to serious penalties for physicians and health care professionals found to have committed information blocking.

Report Aims to Catalyze Texas Medicaid’s Shift to Value-Based Care - 11/02/2023

A new report aims to accelerate Texas Medicaid’s transition from a fee-for-service payment model to a value-based one, a shift that has been underway for 25 years.

First-Ever MIPS Penalties Surface; Share Your Story With TMA - 10/16/2023

Given recent changes to Medicare’s Merit-Based Incentive Payment System (MIPS) and an ongoing push for Medicare physician payment reform, the Texas Medical Association encourages member physicians who participate in MIPS to closely review their final scores for the 2022 performance year.

Help Patients Make Wise Choices About Treatment Options - 07/20/2023

Tools are emerging to help physicians overcome the time constraints that can preempt discussions with patients.

Quality Improvement: Practice Awards and Free Webinars - 07/20/2023

TMA, the Texas Osteopathic Medical Association (TOMA), and the TMF Health Quality Institute are collaborating again to provide the Physician Practice Quality Improvement Award program. The award formally recognizes physician practices for their dedication and commitment to providing high-quality patient care and improving outcomes.

Driving the Quality Train: TMA Physicians Lead the Way, From Measures to Standardization - 07/10/2023

In a proactive effort to resolve physician complaints, TMA and its members are deeply involved in quality issues, from participating in the development of new measures to pushing payers for standardized quality programs and supporting physicians who are curious about value-based care.

Texas Physicians Push to Improve Health Care for LGBTQ Patients - 06/28/2023

Lesbian, gay, bisexual, transgender, or queer/questioning (LGBTQ) patients face unique barriers that put them at greater risk for mental and physical health problems. Often, their health disparities result from a lack of family support, public prejudice, and fear of the health care system. Texas physicians have launched a new workgroup and are adapting their practices to treat this underserved population.

A Shelter From the Practice Viability Storm: TMA Braces Physicians Amid Economic Headwinds - 05/31/2023

TMA is here to help all practices – regardless of setting or payment model – thrive, remaining steady in its advocacy at the state and federal levels to protect physician autonomy and to defend against the corporate practice of medicine.

TMF Offers Resources to Navigate CMS Requirements - 05/16/2023

TMF has launched three physician-focused networks designed to save time, improve patient care, and reduce costs associated with meeting these requirements. These programs, focused on immunizations, behavioral health and value-based improvements, are designed to help physicians benefit from—and not be penalized by—these mandates.

Going Nowhere: APM Committee Resignations Cast Doubt on Payment Models' Future - 05/10/2023

Resignations from HHS advisory committee cast doubt on future of physician-created alternative payment models.

Learning Through a Value Lens: Texas Medical Students Learn Value-Based Care Tenets - 04/30/2023

The national Students and Trainees Advocating for Resource Stewardship (STARS) program seeks to catalyze physicians' uptake of value-based care, starting with medical students, whom it anticipates will have long, impactful careers.

MIPS Value Pathways Registration Now Open - 04/25/2023

Physicians in search of an alternative to Medicare’s Merit-Based Incentive Payment System may be in luck.

Submit 2022 MIPS Data by March 31 to Avoid 9% Medicare Payment Cut - 03/28/2023

The data submission period for Medicare’s 2022 Merit-Based Incentive Payment System (MIPS) performance year is underway and closes on March 31 at 7 pm CT. At stake is a pay cut of up to 9% in the 2024 payment year.

Advanced APM Incentive Payments Extended Through 2023 Performance Year - 03/02/2023

Physicians who participate in an advanced alternative payment model this year will remain eligible for incentive payments – albeit smaller ones – that were initially slated to expire in 2022.

Medicare Bundled-Payment Model Could Expand Access to Value-Based Specialty Care - 01/26/2023

Medicare’s recent extension of a bundled payment model marks a rare opportunity for more specialists to participate in value-based care and could pave the way for better coordination with primary care.

New TMA Task Force on Alternative Payment Models Charts a Path Toward Value-Based Care - 01/26/2023

The shift from fee-for-service to value-based care is underway, with public and private payers introducing myriad new payment models in recent years. But many physicians find the variety of plans overwhelming, and the investments necessary to support them challenging.

Medicare Extends Deadline for MIPS Hardship Relief - 01/09/2023

Having some prohibitive trouble reporting your 2022 data for Medicare’s Merit-Based Incentive Payment System (MIPS)? Maybe the COVID-19 pandemic caused it. Maybe it stems from a natural disaster in your region. Maybe your technology vendor has gone out of business or had some other problem.