Insurer and medical association launch accountable care physician resource

In what is being called a first-of-its-kind joint effort, the Texas Medical Association (TMA) and Blue Cross and Blue Shield of Texas (BCBSTX) are launching a resource initiative to assist independent physicians with providing accountable care.

TMA PracticeEdge LLC will provide independent physicians with tools and resources to reduce the growing data-entry burden, including:

• Consultations to help reduce administrative burdens so they can spend more time focusing on patient care, and

• help for practices wishing to create care management teams to better serve patients with complex or chronic health problems.

TMA's membership includes more than 48,000 Texas physicians and medical students. BCBSTX serves more than 5 million members in all 254 Texas counties. Last month, BCBSTX launched three new physician-led accountable care organizations (ACOs).

This partnership is “fascinating, unique, and well-timed,” says Kip Piper, MA, FACHE, an advisor with Sellers Dorsey, a healthcare consultancy in Washington, D.C.

“Small and solo physician practices are integral to patient care in many parts of the United States, including much of Texas,” Piper tells Managed Healthcare Executive. “These practices need help, a new infrastructure, a new support system to participate in accountable care organizations and meet the increasing clinical, economic, and administrative expectations of Medicare, state Medicaid programs, and private payers.”

In addition to helping the physicians adapt and take advantage of the ACO model, TMA PracticeEdge could be a big winner for both the Texas Medical Association and Blue Cross Blue Shield of Texas, according to Piper.

“TMA is able to expand the value of its services to its members and BCBSTX is able to work more closely with physician practices to improve outcomes and manage costs,” he says. “Patients win by being able to see their physicians while also benefiting from a higher performing delivery system.”

NEXT: Connecting physicans with patients

Approximately two-thirds of Texas physicians work for themselves or in practices that are wholly owned and controlled by other physicians, according to the 2014 TMA Survey of Texas Physicians. Most of these independent physicians traditionally have not had access to the tools and resources needed to participate in an ACO.

“Small physician practices face extraordinary challenges in adapting to value-based payment and new care delivery models,” Piper continues. “Success, even survival in the new, rapidly changing marketplace requires small and solo physician practices to adapt. We cannot afford to lose these docs or push them out of the market.  On the other hand, care delivery must change to improve outcomes and control costs.  Physicians are key to this but they need help.” 

While most ACOs are constrained by a specific hospital system, TMA PracticeEdge will help connect physicians centered on the needs of their specific patients, as well as offer participating physicians the means to provide coordinated collaborative care, including prevention and management of chronic disease.

"This represents a significant investment in our relationship with the TMA and Texas physicians, and will benefit our members, who value their relationships with their independent physicians," Bert Marshall, President of Blue Cross and Blue Shield of Texas, said in a press release.