Texas Institute for Health Care Quality and Efficiency

Medical Regulation, Texas Style

The Texas Institute for Health Care Quality and Efficiency Draft Report is posted for public comment.

You only have a day and a half to comment, since the next meeting of our Board of Directors is Thursday, November 15th. All comments should be sent by 1 PM on Wednesday, November 14th.

Report to the Texas Legislature on Activities to Improve Health Care Quality and Efficiency
Report Number: 2012-001

The following downloads are available:
Report 2012-001: 2012-001-Draft-Report.pdf
Appendix E: AppendixE.pdf
Appendix F: AppendixF.pdf

Instructions on submitting your comments are here.

Now, for a few comments on my observations as a Board member:

Believe it or not, the time frame from the passage of the legislation in SB 7 last June, 2011, to today and in anticipation of preparing for legislation beginning in January, 2013, is too tight. The Institute’s staff and coordinators did a good job of herding cats in the Board. In addition, the Board members worked hard to make all the meetings, to participate, and to contribute. We have met at least once a month, sometimes more than twice, since our appointment. The Board isn’t paid or even reimbursed for expenses by the State, and many gave up work in order to attend meetings far from their homes.

I haven’t commented on the draft until now, because the Board received our first full copy for review and comment on November 2, and comments were due by 5 PM, Election Day, November 6th. We’re all appointed by the Governor — it stands to reason that a few of us would be actively involved in the election and campaigns. I didn’t even open the email until Nov. 7.

I’m not happy with the length of the report, but I guess the nuances of our discussions over the last few months needed to be documented somewhere. Go to the page 34 in the pdf, numbered “26” in the Draft, for the actual recommendations made by vote in the Board meetings.

Finally, my main concern has been with the bureaucracy and regulation that the members of the Board have sometimes appeared to support. In the end, I believe that we have limited recommendations for regulation and “hassle factors” more than some would like. My hope is that the Legislature will decide to focus initially on implementing any new measures in our own State health plans and not interfere directly in private health care practice and systems, except where and when the State foots the bill.

Since President Obama won reelection, I believe that the ability of the 83rd Texas Legislature to adapt and react to Federal Regulations  – Obamacare – will be improved by the work of the Institute.

@GovernorPerry appointed me to Texas Institute for Health Care Quality and Efficiency

I can’t say the whole name of the Institute in one breath, so I alternate between calling it “the Institute,” or “tick” for “TIHCQE.”

TIHCQE will make recommendations to the Texas Legislature on how to measure quality and efficiency and help bring innovation to cut costs while still taking care of our Medicaid patients, those who have State health plans, and future “health care collaboratives” or HCC’s. The latter could be the Accountable Care Organizations that are laid out in the Accountable Care Act (“Obamacare”), or something brand new in Texas.

Anyway, I sent out this notice this morning:

For immediate release:
Reference: http://governor.state.tx.us/news/appointment/17014/

Governor Rick Perry Appoints Beverly B. Nuckols, MD, FAAFP, to Texas Institute for Health Care Quality and Efficiency

Austin, Texas – Texas Governor Rick Perry has appointed New Braunfels Family Physician, Beverly B. Nuckols, MD, FAAFP, to the Board of Directors of the Texas Institute for Health Care Quality and Efficiency, for a term to expire January 31, 2013.

The 82nd Legislature created the Texas Institute for Health Care Quality and Efficiency as part of Senate Bill 7.  The Institute is charged with improving health care quality, accountability, education and cost to the state by encouraging health care provider collaboration, effective health care delivery models and coordination of health care services.

Nuckols, a board certified family physician in private practice, has lived in New Braunfels with her husband, Larry, since 1993. She is a member of the Texas Medical Association, American and Texas Academies of Family Physicians, and the Comal County Medical Association. Nuckols serves on the Board of Directors for Texas Alliance for Life, New Braunfels Options for Women and is the Chair of the Family Medicine Section of the Christian Medical and Dental Association. She has served as a member of the National Advisory Committee on Violence Against Women and the Texas Association Against Sexual Assault, and a board member of the Comal County Women’s Shelter and New Braunfels Hospice.

Nuckols received a bachelor’s degree from the University of Texas at Tyler, and completed medical school and family practice residency at the University of Texas Health Science Center in San Antonio.  She received a Masters in Bioethics in 2007 from Trinity International University in Deerfield, Illinois.

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