There are two kinds of people who don't say much: those who are quiet and those who talk a lot.

 
Half of being smart is knowing what you are dumb at.

IN THIS ISSUE, FOR YOU:
ON THE SCHEDULE AND DISTRICT MEETINGS
BORDELON TO HEAD STATE WORKERS' COMP DIVISION
FALKENBERG: SAD PARADOX EXISTS IN U.S. HEALTH CARE
DID YOU KNOW YOU CAN GET FREE EMAIL ALERTS ON DRUGS, RECALLS, ETC.?
ROADMAP TO MEDICARE COVERAGE, CODING AND PAYMENT, FROM CMS
MISSING FLASH DRIVE CONTAINS 1,200 TEXAS PATIENTS' AIDS, HIV INFORMATION
JOHN CORNYN LIKES MCCAIN'S CALL FOR BIG SHIFT ON HEALTH CARE
AOA AND AOAMI TO SPONSOR E-PRESCRIBING CONFERENCE 
THREE C.O.M.S RANK ABOUT BEST IN NATION
HIDDEN TREASURES IN PAYER PERFORMANCE
"LAUGH AS MUCH AS YOU BREATHE AND LOVE AS LONG AS YOU LIVE." 

ON THE SCHEDULE AND DISTRICT MEETINGS:

District 8       Thursday, Sept. 25th, 6:30 p.m.
                   Utopia World Cuisine
                   Corpus Christi, TX

District 17     Thursday, September 25, 2008, 6:30 p.m.
                   La Scala Restaurant
                   San Antonio, TX 
                   Speaker will be Paul Saenz, D.O.

District 10        Saturday & Sunday, Sept. 27-28th
  CANCELLED   Inn of the Mountain Gods
                      Riudosa, New Mexico
   
Sept. 12th     White Coat Ceremony, UNTHSC/TCOM, 2 p.m.
                   Will Rogers Auditorium, Fort Worth, TX

Sept. 13th     TOMA Board meeting, 9 a.m.,

                   Room EAD 810 

                   UNTHSC, Fort Worth, Tx
 
September     Prostate Cancer Awareness Month
October        Breast Cancer Awareness Month

BORDELON TO HEAD STATE WORKERS' COMP DIVISION
Austin American-Statesman - August 28, 2008

Gov. Rick Perry on Wednesday shook up the leadership in the two state agencies that oversee the insurance industry. Rod Bordelon, now the director of the Office of Public Insurance Counsel, was appointed commissioner of the Workers' Compensation Division of the Texas Department of Insurance. Bordelon has served as the consumer advocate in the state's insurance regulatory system since 1995. He is succeeding Albert Betts, who announced his resignation in June. To replace Bordelon, Perry named Deeia Beck as the public insurance counsel. Beck is an administrative law judge in the Workers' Compensation Division.
http://www.statesman.com/news/content/news/stories/local/08/28/0828insurance.html

From:  Quorum Report, EDITOR: Harvey Kronberg, www.quorumreport.com

FALKENBERG: SAD PARADOX EXISTS IN U.S. HEALTH CARE
Houston Chronicle - August 28, 2008

Kelly is caught in a sad, patently unfair paradox of American health care. Patients forced to pay out of pocket - be they the 45.7 million uninsured Americans, or international visitors - are charged the most. How much? More than three times what the government allowed Medicare patients to be charged in 2004, and often 2.5 times what most health insurers actually paid, according to a 2007 study by Gerard Anderson, a professor at the Johns Hopkins Bloomberg School of Public Health. The gap exists because self-pay patients don't have the government or an insurance company to negotiate lower rates with hospitals. At M.D. Anderson, Kelly was charged a $175 clinic fee each time she reported to chemo, a charge that Holly Wallack, a patient advocate Kelly hired, calls redundant and one that insurers refuse to pay. Kelly also was charged more than $6,300 for a drug, a markup of at least 400 percent from the lowest listed wholesale price, Wallack said.
http://www.chron.com/disp/story.mpl/metropolitan/falkenberg/5971068.html

From:  Quorum Report,EDITOR: Harvey Kronberg, www.quorumreport.com

DID YOU KNOW YOU CAN GET FREE EMAIL ALERTS ON DRUGS, RECALLS, ETC.?

The U.S. Food & Drug Administration (FDA) offers you a free e-mail subscription service. When you subscribe to this service, you will receive an e-mail message each time there is an update on the FDA page(s) you select.
Among the many alerts, notices, and information about drugs, recalls, medical devices, etc., that you are received are:

MedWatch Safety Alerts
Medical product safety alerts, Class I recalls, market withdrawals, and public health advisories

Drug Safety Newsletter
Postmarket information for healthcare professionals on new drug safety information and reported adverse events

Drug Shortages
Notification about drug products added to the Current Drug Shortages and Resolved Drug Shortages lists

To subscribe to this service or update your subscriber preferences, please enter your e-mail adddress below.
https://service.govdelivery.com/service/subscribe.html?code=USFDA_46

Just select the notices you want to receive; they are free to you on your email.
Or go to the Food and Drug Administration website at www.fda.gov and about a third of the way down on the right side of the page, click on  Sign Up for FDA's Recalls E-List

ROADMAP TO MEDICARE COVERAGE, CODING AND PAYMENT, FROM CMS

On Aug. 25, CMS released The Innovator's Guide to Navigating CMS. The guide "provides a roadmap to Medicare coverage, coding, and payment," CMS says. Visit www.cms.hhs.gov/CouncilonTechInnov/Downloads/InnovatorsGuide8_25_08.pdf

From:  GOVERNMENT NEWS OF THE WEEK, Atlantic Information Services, Inc. (AIS), http://www.AISHealth.com.

MISSING FLASH DRIVE CONTAINS 1,200 TEXAS PATIENTS' AIDS, HIV INFORMATION 

 
A Harris County Hospital District employee probably violated federal law when she downloaded medical and financial records of more than 1,000 patients with HIV, AIDS, and other conditions onto a flash drive that was either lost or stolen, The Houston Chronicle reported August 7.
 
An employee of the hospital district transferred the data to complete a project away from the office and now is unable to find the device, the newspaper first reported August 6. "We are deeply concerned about this matter and are working with our patients to address their concerns and provide them with appropriate personal identity protection services," the 28-facility hospital district said in a statement released to the newspaper.
 
The hospital district's statement did not specify the type of information stored on the device, beyond describing it as PHI, the newspaper reported August 6. Hospital district officials initially declined to provide information beyond that provided in its written statement.
 
Click here to read the August 6 article:  http://www.chron.com/disp/story.mpl/headline/metro/5931497.html

Click here to read the August 7 article:  http://www.chron.com/disp/story.mpl/headline/metro/5929121.html

From:  EHR Connection, HCPro, Inc., www.hcmarketplace.com

JOHN CORNYN LIKES MCCAIN'S CALL FOR BIG SHIFT ON HEALTH CARE
Dallas Morning News - September 2, 2008

Sen. John Cornyn has endorsed presumptive GOP presidential nominee John McCain's proposal to try to shift health insurance away from being a benefit received from your employer to a commodity that virtually all Americans purchase as individuals and families in the private marketplace. "There's no reason today to have health insurance policies tied to employers," Cornyn told reporters on Monday. He said he's stunned by how many people today won't take new jobs because they fear the policy at their new employer won't cover their chronic conditions. And he joined McCain -- and President Bush -- in arguing that the current tax code is unfair because the self-employed and owners of small businesses pay taxes fully on their income and then buy themselves a health plan, while most of us who get health insurance from our employers aren't taxed on the portion our boss pays -- usually 70 percent.

"There's no reason today to have health insurance policies tied to employers," Cornyn told reporters on Monday.
He said he's stunned by how many people today won't take new jobs because they fear the policy at their new employer won't cover their chronic conditions. And he joined McCain -- and President Bush -- in arguing that the current tax code is unfair because the self-employed and owners of small businesses pay taxes fully on their income and then buy themselves a health plan, while most of us who get health insurance from our employers aren't taxed on the portion our boss pays -- usually 70 percent.

But there's a potential political landmine here: McCain would tax workers on the value of insurance they receive from their employers.
http://www.dallasnews.com/sharedcontent/dws/news/politics/topstories/stories/081608dnpolmccainhealth.43edf6d.html

From:  Quorum Report, EDITOR: Harvey Kronberg, www.quorumreport.com

From:  Dallas Morning News

AOA AND AOAMI TO SPONSOR E-PRESCRIBING CONFERENCE 

The AOA is proud to announce that the Centers for Medicare and Medicaid Services have selected the AOA and the American Osteopathic Association of Medical Informatics (AOAMI) as co-sponsors of the CMS National E-prescribing Conference, which will be held 10/6-7/08 in Boston, MA. This Conference aims to educate providers and beneficiaries on the Medicare Improvements for Patients and Providers Act of 2008 E-prescribing program to help promote the adoption of e-prescribing throughout the health care community.  Other conference sponsors include the American Medical Association and the AARP.

Register Today! Be part of a groundbreaking opportunity. CMS along with industry partners from health and technology are hosting a National E-prescribing Conference on October 6 - 7, 2008 at the Sheraton Boston Hotel, Boston, MA.
Our goal in holding this conference is to educate providers and beneficiary constituencies on the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) e-prescribing program and help promote the adoption of e-prescribing throughout the health care community. 

Join us to find out how to earn incentives from Medicare, learn how e-prescribing can work for your business, and get answers to your questions about privacy, security, and risk management. Register for the conference now at www.e-prescribeconference.com .

http://www.epsilonregistration.com/er/EventHomePage/CustomPage.jsp?ActivityID=378&ItemID=1117

From:  American Osteopathic Association and "The Region VI Insider," CMS Regional Office in Dallas, TX

THREE C.O.M.S RANK ABOUT BEST IN NATION 

Three osteopathic medical schools were ranked in the Hispanic Business Journal's list of the 20 best medical schools for Hispanic students.  The University of North Texas Health Science Center Texas College of Osteopathic Medicine (UNTHSC-TCOM), Edward Via Virginia College of Osteopathic Medicine (VCOM), and the A.T. Still University Kirksville College of Osteopathic Medicine (KCOM/ATSU) were all ranked in the top 20 best medical schools for Hispanic students because of the large percentage of Hispanic enrollment, dedication to underserved communities, and Hispanic faculty and programs.  Read more online: 
http://www.hispanicbusiness.com/news/2008/8/28/the_second_10_nos_1120_best.htm

HIDDEN TREASURES IN PAYER PERFORMANCE
 
There are many reasons to be annoyed with practice economics: Medicare's annual threat to reduce reimbursement, third party payers seeking ways to ratchet down payments are just two. But you do have some control. Maybe it's time to see what you can do to change things to your benefit, such as renegotiating payer contracts. Done right, it's an effective strategy to boost practice revenue, and before you roll your eyes, rest assured that it can be done.
Case in point: I was recently in a practice that was seeing far more patients than average, and netting far less. Their expenses were under control, but after analyzing their payer mix, it was clear that this group would need to renegotiate certain contracts or make the tough decision to drop payers. One payer, who represented 10 percent of the patient panel, was reimbursing less than it would cost to treat a patient. Ouch!

To get a better picture of what your payers are paying, start working the numbers. Collect payment data for a six month period and put it in a simple spreadsheet that examines your top five payers and code utilization. You'll want to compare the following:

*  Percentage of total revenue for each payer. This will tell you if you are top-heavy and, therefore, vulnerable.
*  Average reimbursement by payer for each of your top ten CPT codes, compared to your fee schedule. Also calculate average reimbursement by payer when the top ten codes are combined. In other words, where are you taking the biggest hit?
*  Analyze reimbursements against your average cost to see a patient. This can be estimated by dividing total revenue (over a six month period) by the number of patient visits in the same period.
*  Compare your average costs and reimbursements per patient to the national average using data available through your specialty society, MGMA's cost survey for physicians, or the Physicians Practice Fee Schedule Survey.

If this analysis reveals a bleak picture, there are things you can do. First and foremost, develop a strategy to improve your payer reimbursements. Examine your practice performance and develop how you'll renegotiate your contracts. Here are a few points to consider:

How much does your payer need you? If you are only one of a few physicians in your specialty serving a large pool of patients, this is a big advantage.

What do you do well? Are your emergency admittance rates and days in the hospital lower than comparable practices in your area? Are your patient satisfaction scores stellar? If you offer open access scheduling or some other patient-retaining service, tout it.

Seek out pay-for-performance initiatives that guarantee higher reimbursement rates or bonuses for top performers. You might be surprised how much this can add to your bottom line.

Next, if negotiation fails, consider dropping your worst payers. Remember, this doesn't mean you are abandoning your patients. You can see patients out of network; just make sure you send out a letter informing your patients that you are no longer contracting with their insurance plan, but would like to continue their care. Be careful not to paint an unfavorable picture of their insurer.

While you're at it, tighten up all of your financial policies, such as collecting copays upfront before treatment.
Most importantly, develop a plan and stay in charge of your own future. By focusing on your strengths -- providing great customer service, creating an environment where patients are at ease, and giving excellent medical care -- the rest will come easier.

Judy Capko is a healthcare consultant, speaker, and author of the popular books "Secrets of the Best Run Practices, 2006" and "Take Back Time, 2008." She is a popular speaker at national and regional conferences. Judy is the owner of Capko & Company, www.capko.com, based in Thousand Oaks, Calif. She can be reached at judy@capko.com. 

From:  Physicians Practice Pearls, by Physicians Practice, www.PhysiciansPractice.com

.

"LAUGH AS MUCH AS YOU BREATHE AND LOVE AS LONG AS YOU LIVE." 

 
A little girl had just finished her first week of school. "I'm wasting my time," she said to her mother.
"I can't read, I can't write - and they won't let me talk!"

Fan Belt:  What a football supporter uses to keep his trousers up

Sattinger's Law: It works better if you plug it in.

Gold's Law: If the shoe fits, it's ugly

I believe that if anything is worth doing, it would have been done already.

When someone says this is as bad as it can get, don't bet on it.

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