Page 8 - Bexar County Medical Society Purchasing Directory

PRESIDENT’S
MESSAGE

The Bad, The Ugly and

The Good By Adam Ratner, MD, 2019 BCMS President

The Bad The Good
I’m writing this more than a month before you will read this. I Organized medicine in Texas has met and defeated similar bills
hope by the time your copy of San Antonio Medicine lands on your in the past. Sb 1264 will be met by the full force of the TMA and
desk in April, we’ll have some good news about Senate bill 1264, bCMS advocacy teams in an effort to defeat it, as well.
the so-called “surprise billing” bill. Many of us who pay attention Physicians are brilliant and hard-working and have the intellectual
to the happenings in Austin were expecting something like this to firepower to work around challenges and threats to our patients and
emerge. Here is a key excerpt from the bill regarding physicians who our practices. Perhaps it’s time to think seriously about changing
provide emergency services or are facility-based as it is published your relationships with third-party payors and deal one-on-one fi-
on March 2, 2019: nancially with your patients, if you can in your specialty.
A non-network physician or provider may not bill a patient described by
this section in, and the patient has no financial responsibility for, an Allying with the Alliance
amount greater than the patient's responsibility under the patient's health We physicians in the bCMS are not alone. We have our bCMS
care plan, including an applicable copayment, coinsurance, or deductible. Alliance.
because of the joint vision and leadership of the immediate past
The Ugly presidents of the bCMS and the bCMS Alliance last year, Sheldon

Those of us who have had the “privilege” of negotiating physi- Gross and Jenny Shepherd, Kelly King, the current bCMS Alliance
cian services contracts with third party payors will immediately grasp president, and our bCMS and Alliance Executive Committees, all
that should Sb 1264 and a proposed companion house bill become of us are beginning to see the benefits.
law, it will eliminate virtually any remaining incentive for any payor Within a couple of days following the recent bCMS Executive
to negotiate contracts fairly with a physician who is facility-based Committee’s approval of developing a physician mental health/sui-
and/or provides emergency services. cide prevention program (modeled after Travis County Medical So-
As it has been for years, the root of this problem is the lack of ciety’s program), three Alliance leaders volunteered to work on the
motivation of many third-party payors to work with willing and co- program. during this same time period, three Alliance leaders
operative physicians to create and maintain adequate networks to stepped up to help advise our bCMS library Philanthropy board
serve our patients. Whether you practice solo or in a small, medium headed by dr. Gerry Ortega. Finally, two Alliance leaders signed up
or large multispecialty private, corporate or academic group, almost to participate in the 2019-2020 second annual Physician leadership
all physicians who provide emergency or facility-based care will be development Program.
adversely affected. For the majority of bCMS members who have not had the priv-
There is another ugly side. There are a few doctors whose prac- ilege of working with the Alliance or participating in their social
tices are sending patients outrageous bills. I’m not sure whether and philanthropic events, you and your spouse are missing out. The
all of the practices that send these bills realistically expect to be events are fun! The Alliance leaders and active members are pas-
paid these huge sums, but on occasion some patients have been sionate individuals who are making a major difference in the lives
sent to collection agencies for inadequate payment. Proponents of those they touch, within the Alliance and bCMS as well as the
of Sb 1264 are using these outlier instances to attack the rest of greater community.
us. Enough said. The Alliance leadership has come forward to work with the

8 San Antonio Medicine • April 2019