The Texas Medical Association (TMA) and Blue Cross Blue Shield of Texas are launching a new services company, TMA PracticeEdge, to facilitate bringing the benefits of value-based reimbursements to the state’s independent physicians.
Independent practitioners face challenges to participating in (and benefitting from) alternatives to fee-for-service payment, such as having the funds necessary to invest upfront in resources for improved care management. TMA PracticeEdge aims to help providers address the barriers. The company, for example, will offer consultations on basic practice management and administrative simplification, assistance with the implementation of health information technology infrastructure, and experience with risk-based contracts. Additional services will be available for practices interested in creating care teams or developing an Accountable Care Organization.
Texas is an ideal locale for a large-scale initiative to support the ongoing survival of independent practitioners. According to a 2014 survey conducted by The Physicians Foundation, only 35 percent of physicians described themselves as independent practitioners, down from 49 percent in 2012 and 62 percent in 2008. According to various TMA publications, approximately 34 percent of Texas physicians are solo practitioners, while another 38 percent are in small groups of two to six physicians. Notable, however, is that the initiative does not appear to preserve the status quo for independent physicians; there is recognition, be it implicit or explicit, that some degree of structural integration and interoperability is necessary in the evolving healthcare landscape.
While management services organizations are not a new concept in healthcare, TMA PracticeEdge is unique in its potential scope, size, and scale. It will be interesting to see how the details develop—what the service and product lines ultimately entail, how much they cost, and how savings, if achieved, are apportioned. Until such information is known, it is difficult to estimate how well physicians will respond to the venture and whether the expected efficiencies will be significant enough to really help independent practitioners stay independent.