Publications by authors named "Joey Berlin"

"We believe that standardizing those kind of processes will be easier for [those] providing care. Because one of the things we hear a lot is this lack of harmonization of processes and procedures, whether that's in care or measures or processes. That is a really important part of it.

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Obstacles to Clear.

Tex Med

September 2021

Barriers stand in the way of physicians playing a greater role in addressing the social determinants of health, but awareness of those factors is increasing, and progress is happening.

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The Texas Legislature's investment in medical education includes a full commitment to GME.

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Pushback from patients on medical advice and course of treatment is nothing new. But physicians say the degree of it - a lack of trust in science, medicine, and expertise - has never been as pronounced as it is now, in the era of the highly contagious delta variant, widespread availability of COVID-19 vaccines, and millions of people who simply refuse to avail themselves of them. And it's piling onto the already-existing assaults on physician mental well-being - now increasingly framed as physician "moral injury.

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A decade ago, the Texas Legislature made a funding decision that devasted low-income women's access to health care and the physicians and community clinics that care for them. After 10 years, with the help of TMA advocacy and the formation of the Texas Women's Healthcare Coalition, funding for family planning and overall women's health is in significantly better shape.

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When Andrew Indresano, MD, got a subpoena in January 2019, he found it "a little shocking" and "really invasive." The Fort Worth orthopedic surgeon wasn't even part of the personal-injury lawsuit for which he was being asked to produce a backward-looking swath of documents.

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Challenges to Texas laws governing end-of-life care, whether through legislative rewrites or judicial override, are nothing new. The recent success of those challenges is. In particular, two recent erosions have physicians like Houston palliative care specialist Mark Casanova, MD, chagrined and concerned about the future of doctors' role in end-of-life treatment.

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A court decision siding with chiropractors is the latest of many scope tests in the legislature and the law.

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The Texas Alliance for Patient Access (TAPA) announced in early March that Sen. Kelly Hancock (R-North Richland Hills) and Rep. Jeff Leach (R-Plano) would soon file COVID-19 liability legislation that would enhance liability protections to shield more physicians from lawsuits for care delivered during pandemics, hurricanes, and other catastrophic events that inject chaos into their good-faith medical efforts.

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Congress in December 2020 passed surprise-billing legislation as part of a wide-ranging coronavirus relief bill, tying a bow on federal lawmakers' primary health care focus just prior to COVID-19. Texas already had set up its own system for state-regulated plans in 2019 with Senate Bill 1264, which took effect last year.

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COVID-19 has made a booming illicit business - ransomware - boom even louder. And the more medical practices and organizations fall victim to ransomware cyberattacks, the more illustrative it becomes how important it is to prevent such an attack.

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TMA fights decision that could strip physicians of their ability to exercise their conscience.

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Two recent studies suggest expanding Medicaid will not only save Texas money, but add to the Lone Star State's coffers.

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Thanks in large part to COVID-19, telemedicine has arrived. Where does it go from here? That was much of the focus of a Telehealth Virtual Bootcamp, an Aug. 29 presentation by the Telehealth Initiative that touched on technology, applications, and payment.

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Priority: Primary Care.

Tex Med

December 2020

The Texas Medical Association and other corners of organized medicine know primary care is part of the bedrock of a sturdy health care system. So medicine - including the Texas Primary Care Consortium (TPCC), of which TMA is a member, and the Texas Academy of Family Physicians (TAFP) - is engaging policymakers to not only help the state's primary care system survive the pandemic, but also enable it to thrive for the long haul.

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TMA is developing a promising, locally focused version of the accountable care organization (ACO) model that could help cover uninsured and underinsured Texans who fall in the gap or "hole" in the state's safety net: those who make too much money to qualify for Medicaid coverage as it's now administered in Texas, but also don't qualify for Medicare.

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For the Medicare Shared Savings Program (MSSP) and many of the accountable care organizations (ACOs) that participated in it, 2019 was billed as a transition year. But data released by the Centers for Medicare & Medicaid Services (CMS) in September show Texas ACOs fared quite well last year - and a number of Texas physicians and ACO officials say the savings generated are worth the gruntwork that MSSP requires.

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The malaise in physician practice long known as burnout - a term doctors increasingly balk at - has been exacerbated by the pandemic, as an extensive survey by the Physicians Foundation recently showed. It's created its own stressors and made existing ones worse.

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A newly revised Texas Medical Association CME teaches physicians how to recognize human trafficking victims who come into their office, and how to help these patients escape what's sometimes referred to as "modern-day slavery."

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As the Centers for Medicare & Medicaid Services continues to churn out glowing data annually on its Quality Payment Program (QPP), a full picture of the program's impact eludes the agency's reporting. According to the Texas Medical Association's analysis of state-level data in the 2018 QPP Experience Report, it's clear that small practices continue to feel most of the program's punitive pressures.

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For too long, some doctors say measures of a physician's quality of care have been about process: the average length of a patient stay, for example, or a patient's readmission rate. The bottom line is results, and that's why a shift to patient-reported outcome (PRO) measures is necessary. However, even proponents of PRO measures note that collecting the information from patients for those metrics places burdens on physicians, and some remain skeptical of bonuses and penalties tied to a measure that derives from a subjective factor: what patients think.

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The way the Texas Legislature conducts business during the 2021 session may look different due to the COVID-19 pandemic. But the Texas Medical Association's commitment to improving health care remains the same. Some of those goals are up against deep cuts to state agency budgets.

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Physicians believe some payers are taking advantage of COVID chaos with their drug policies, but also see some plans taking steps to make care easier during the pandemic.

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Now that Texas prescribers must check a patient's history in the state's prescription monitoring program (PMP) before prescribing opioids, plus three other drug classes, the errors are becoming more apparent.

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Each election, TEXPAC, the Texas Medical Association's nonpartisan political arm, throws its support behind candidates who have demonstrated their support for a medicine-friendly agenda.

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