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able from one health system, such as UTHealth’s. “Having access to Medicare claims


data allows us to track patients not just [by analyzing] one visit, but you can track them across time and across providers,” Dr. Ganduglia-Cazaban said. “Even if they went into one hos- pital and then got into a different ER from another system, and then into another hospital, you can track these patients and see them as they move across providers and across time.”


HOW THE DATA CAN HELP


Texas’ car-clogged cities, sparsely populated counties, and locales in between all have their own stories to tell when it comes to health care qual- ity. Drilling into the Medicare data can help reveal objective truths about those stories and perhaps drive health care policy change. -7= MO\^S ON [_KVS ON OX^S^SO] K\O


required to use the Medicare data they receive to produce reports on practi- ^SYXO\ ZO\PY\WKXMO -7= MO\^S ON " [_KVS ON OX^S^SO] P\YW ^Y 8Y` 2016, according to its website. While ]YWO YP ^RO [_KVS ON OX^S^SO] PYM_] YX data from the entire nation, others fo- M_] ]ZOMS MKVVc YX YXO ]^K^O Y\ O`OX on a small number of counties in one or a few states. “If you look at the map of the quali-


ON OX^S^SO] KM\Y]] ^RO MY_X^\c ^RO\Ot] a big gap in the South, and certainly in Texas,” said Trudy Krause, PhD, who codirects the center with Dr. Gandug- lia-Cazaban. “So we wanted to be the ones that would pick up that role and be able to do that process.” Dr. Ganduglia-Cazaban says the metrics of a given area with a high diabetes prevalence, for example, can reveal whether that population is get- ting the right diabetic preventive care. “You can measure overall in Texas, but what we can really do with this data is identify areas in which either


+


education programs or preventive programs could help solve situations and improve the care for that popu- lation,” she said. “The same thing would go for other diagnoses, like cancer diagnoses: Do we have areas in which we know that we have a higher Z\O`KVOXMO YP K ]ZOMS M ^cZO YP MKXMO\ or cancer overall, and what care are these patients receiving there? Can we do something to improve their care in that area?” Bradly Bundrant, MD, an emergen-


cy physician in rural Ballinger, near San Angelo, says the Medicare claims information should be able to reveal facts about patient acuity, as well as costs related to emergency depart- ment patients. “We see a lot of people that come into the ER with high acuity, and they should be able to monitor what hap- pens to them if they get admitted to the local hospital versus if they get transferred, and how many people get admitted to the local hospital and then get transferred. Those are all gauges of quality,” said Dr. Bundrant, a member of the Texas Medical Association’s Ad Hoc Committee on Health Informa- tion Technology. He says the data also should be


valuable for comparing rural hospi- tals like his — one of two in Runnels County. Both are critical-access facili- ties. They’re about 15 miles apart, but the closest hospitals otherwise are 35 to 45 miles away, he says. “I suspect that there is a strong de-


sire to reduce the number of critical- KMMO]] RY]ZS^KV] KXN ^RO \]^ M\S^O\SK probably will be distance,” he said. “If you have two critical-access hospitals that are close to each other, then one of them probably is going to be closed. That’s just the bureaucratic pressure. And one of the best tools to decide which one should be closed should be information like this.” The Medicare numbers should tell


NCQA HEDIS and quality measurement: www.ncqa.org/hedis-quality-measurement


STATEMENT OF OWNERSHIP, MANAGEMENT, AND CIRCULATION. 1. Publication Title: Texas Medicine; 2. Publication Number: 0040-4470; 3. Filing Date: 09/19/2017; 4. Issue Frequency: Monthly; 5. Number of Issues Published Annually: 12; 6. Annual Subscription Price: $20; 7. Complete Mailing Address of Known Ofice of Publication: 401 W. 15th St., Austin, Travis, Texas 78701-1680; 8. Complete Mailing Address of Headquarters or General Business Ofice of Publisher: 401 W. 15th St., Austin, Travis, Texas 78701-1680; 9. Full Names and Complete Mailing Addresses of Publisher, Editor, and Managing Editor: Publisher: Texas Medical Association, 401 W. 15th St., Austin, TX 78701-1680; Editor: David Doolittle, 401 W. 15th St., Austin, TX 78701-1680; Managing Editor: Shari Henson, 401 W. 15th St., Austin, TX 78701- 1680; 10. Owner: Texas Medical Association, 401 W. 15th St., Austin, TX 78701; 11. Known Bondholders, Mortgagees, and Other Security Holders Owning or Holding 1 Percent or More of Total Amount of Bonds, Mortgages, or Other Securities: None; 12. Tax Status: Has Not Changed During Preceding 12 Months; 13. Publication Title: Texas Medicine; 14. Issue Date for Circulation Data Below: September 2017; 15. Extent and Nature of Circulation: (a) Total Number of Copies (Net press run): Average No. Copies Each Issue During Preceding 12 Months: 41,919; No. Copies of Single Issue Published Nearest to Filing Date: 43,015; (b) Paid Circulation: Mailed Outside- County Paid Subscriptions Stated on PS Form 3541: Average No. Copies Each Issue During Preceding 12 Months: 34,578; No. Copies of Single Issue Published Nearest to Filing Date: 35,319; Paid Distribution by Other Classes of Mail Through the USPS: Average No. Copies Each Issues During Preceding 12 Months: 19; No. Copies of Single Issue Published Nearest to Filing Date: 19; Total Paid Distribution: Average No. Copies Each Issue During Preceding 12 Months: 34,597; No. Copies of Single Issue Published Nearest to Filing Date: 35,338. (d) Free or Nominal Rate Distribution (by Mail and Outside the Mail): (1) Free or Nominal Rate Outside-County Copies included on PS Form 3541: Average No. Copies Each Issue During Preceding 12 Months: 7,040; No. Copies of Single Issue Published Nearest to Filing Date: 6,904; (e) Total Free or Nominal Rate Distribution: Average No. Copies Each Issue During Preceding 12 Months: 7,040; No. Copies of Single Issue Published Nearest to Filing Date: 6,904; (f) Total Distribution: Average No. Copies Each Issue During Preceding 12 Months: 41,637; No. Copies of Single Issue Published Nearest to Filing Date: 42,242; Copies not


Distributed:


Average No. Copies Each Issue During Preceding 12 Months: 282; No. Copies of Single Issue Published Nearest to Filing Date: 773; Total: Average No. Copies Each Issue During Preceding 12 Months: 41,919; No. Copies of Single Issue Published Nearest to Filing Date: 43,015; Percent Paid: Average No. Copies Each Issue During Preceding 12 Months: 83%; No. Copies of Single Issue Published Nearest to Filing Date: 84%; 16. Electronic Copy Circulation: N/A; 17. Publication of Statement of Ownership: If the publication is a general publication, publication of this statement is required. Will be printed in the November 2014 issue of this publication. 18. Signature and Title of Editor, Publisher, Business Manager, or Owner: David Doolittle, Editor, 09/20/2017. I certify that all information furnished on this form is true and complete. I understand that anyone who furnishes false or misleading information on this form or who omits material or information requested on the form may be subject to criminal sanctions (including fines and imprisonment) and/or civil sanctions (including civil penalties).


November 2017 TEXAS MEDICINE 49


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