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Health care bills to change Texas payment system

Chris Tomlinson

Two bills introduced into the Texas Senate would change health care billing procedures to encourage doctors to focus on patient outcomes, best practices and maintaining good health, Lt. Gov. David Dewhurst and Sen. Jane Nelson said on Wednesday.

Dewhurst said the U.S. health care system was the most expensive in the world, yet produced poor results. He said Senate Bills 7 and 8 would create free-market incentives for doctors and hospitals to work together to make care more efficient and effective.

"In Texas, we don't have health care, we have sick care," Dewhurst said. "America, almost exclusively, pays doctors based on how many procedures are done, versus paying for good medical outcomes and paying for following best practices."

Senate Bill 7 would overhaul the Medicaid and Child Health Insurance Program payment systems, while Senate Bill 8 would focus on other health care plans for state employees and others. Both would create incentives for doctors and hospitals to provide better health care at a lower cost, Dewhurst said.

"The research shows that in this model, as implemented by the Mayo Clinic, it decreases acute care costs by 28 percent, while increasing the quality of medical outcomes, using the Intermountain example in Salt Lake City, by 40 percent," Dewhurst said.

Representative from the Texas Medical Association and the Texas Hospital Association appeared with Dewhurst and Nelson to endorse the bills.

"The current system of paying for health care is based on volume, not quality," said Dan Stultz, president of the Texas Hospital Association. "Payment reform is needed to change the incentives and reward 'right behaviors,' such as using best practices and evidence-based protocols to improve quality."

Nelson, R-Flower Mound, said the bill would move Texas "toward a payment system that rewards quality outcomes rather than quantity of services."

"I guarantee you, it's not only going to save us money, it will improve and we'll have healthier Texans," Nelson said.

Among other things, the bill would allow doctors and hospitals to collaborate on billing practices, something forbidden under current law.

"Texas hospitals are ready to embrace the concept of health care collaboratives where physicians, nurses and hospitals work together to achieve the best quality results for their patients," Stultz said. Removing antitrust barriers and creating financial incentives . . . will help drive the movement to improve quality, and over time lead to tangible cost savings and better outcomes."

Rep. Lois Kolkhorst, R-Brenham, plans to introduce a companion bill in the House. The Senate bills will now go to committees for public hearings.

The Associated Press