keyword
MENU ▼
Read by QxMD icon Read
search

Insurance reimbursement

keyword
https://www.readbyqxmd.com/read/29671080/-lutetium-177-psma-radioligand-therapy-consensus-within-the-framework-of-gkv-funded-care-between-the-university-hospitals-in-aachen-bonn-d%C3%A3-sseldorf-essen-and-cologne-and-the-mdk-nordrhein
#1
REVIEW
H Ahmadzadehfar, P Albers, A Bockisch, M Boegemann, C Böhme, W Burchert, M Dietlein, A Drzezga, U Fabry, G Feldmann, A Heidenreich, A Heinzel, K Herrmann, A Heyll, C Höhling, C Kreuzer, D Laufer, R Mengel, F M Mottaghy, H-W Müller, S C Müller, E Ost, K Rahbar, W Reifenhäuser, M Schäfers, C Schlenkhoff, M Schmidt, I Schmidt-Wolf, C Wildenhain, B Zimmer, M Essler
In the last 3 years, Lutetium-177 prostate-specific membrane antigen radioligand therapy (Lu-177-PSMA-RLT) has received increasing attention in nuclear medicine as a new form of treatment for castration-resistant metastatic prostate cancer. This therapy combines the radionuclide Lutetium-177, which has been therapeutically used in nuclear medicine for many years, with a molecular target of the transmembrane prostate-specific membrane antigen expressed by prostate cancer cells. Since there are no prospective randomized studies on Lu-177-PSMA-RLT and the question of reimbursement has repeatedly been the subject of review by the MDK Nordrhein (Medischenische Dienst der Krankenversicherung), there was a desire because of the increasing number of patients being treated to clarify under which circumstances Lu-177-PSMA-RLT can be reimbursed by German statutory health insurance...
April 18, 2018: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/29671079/-practice-of-early-detection-of-prostate-cancer-descriptive-survey-in-preparation-for-the-psainform-study
#2
A Simbrich, A Semjonow, N Donner-Banzhoff, H-W Hense
BACKGROUND: The randomized controlled PSAInForm study aims to investigate the effects of a computer-based decision aid which informs men in the age group 55-69 years about advantages and disadvantages of PSA testing. In preparation for the study, the current PSA testing practice in the Münster district was assessed. MATERIALS AND METHODS: The frequencies of early detection examinations, medically indicated PSA tests, and prostate biopsies in the Münster district were determined, using aggregated data from the regional association of Statutory Health Insurance (SHI) Physicians in Westfalen-Lippe...
April 18, 2018: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/29669533/general-analysis-of-factors-influencing-cataract-surgery-practice-in-shanghai-residents
#3
Yi Xu, Jiangnan He, Senlin Lin, Bo Zhang, Jianfeng Zhu, Serge Resnikoff, Lina Lu, Haidong Zou
BACKGROUND: It was reported that lack of knowledge, less confidence of medical services, commute difficulties, and poor economic conditions would be the main barriers for cataract surgery practice. The influencing factors could have changed in cities with high developing speed. Shanghai is one of the biggest cities in China and the world. The purpose of the study was to explore the factors influencing cataract surgery practice in Shanghai. METHODS: This was a population-based, cross-sectional study...
April 18, 2018: BMC Ophthalmology
https://www.readbyqxmd.com/read/29668449/budgetary-impact-of-medicinal-therapies-for-rare-diseases-in-bulgaria
#4
Georgi G Iskrov, Mihajlo Michael Jakovljevic, Rumen S Stefanov
BACKGROUND: Rare diseases have been continually outlined as one of the causes for the National Health Insurance Fund's (NHIF) deficit spending in Bulgaria. AIM: To estimate the budgetary impact of rare disease medicinal therapies from NHIF perspective for 2014 and 2016. MATERIALS AND METHODS: Budgetary impact of rare diseases is calculated as a percentage of NHIF total pharmaceutical spending. Total expenditure per ICD-10 code, mean annual number of patients reimbursed and mean annual cost per patient are analysed...
March 1, 2018: Folia Medica
https://www.readbyqxmd.com/read/29662861/global-hemostatic-assay-of-different-target-procoagulant-activities-of-factor-viii-and-factor-ix
#5
Ki-Young Yoo, Soo-Young Jung, Sung-Ho Hwang, Su-Min Lee, Jong-Ho Park, Hyun-Ja Nam
Background: Korean National Health Insurance reimburses factor VIII (FVIII) and factor IX (FIX) clotting factor concentrate (CFC) infusions to discrepant activity levels, allowing elevation of FVIII activity to 60 IU/dL and FIX to 40 IU/dL. We aimed to assess hemostatic response to these target levels using global hemostatic assays. Methods: We enrolled 34 normal healthy men, 34 patients with hemophilia A, and 36 with hemophilia B, with residual factor activity of 3 IU/dL or less and without inhibitors...
March 2018: Blood Research
https://www.readbyqxmd.com/read/29662748/national-trends-for-primary-and-revision-lumbar-disc-arthroplasty-throughout-the-united-states
#6
Comron Saifi, Alejandro Cazzulino, Caroline Park, Joseph Laratta, Philip K Louie, Jamal N Shillingford, Ronald Lehman, Howard An, Frank Phillips
Study Design: Retrospective database study. Objectives: Analysis of economic and demographic data concerning lumbar disc arthroplasty (LDA) throughout the United States to improve value-based care and health care utilization. Methods: The National Inpatient Sample database was queried for patients who underwent primary or revision LDA between 2005 and 2013. Demographic and economic data included total surgeries, costs, length of stay, and frequency of routine discharge...
April 2018: Global Spine Journal
https://www.readbyqxmd.com/read/29661050/healthcare-resource-use-and-costs-associated-with-chronic-kidney-disease-in-us-private-insurance-patients-with-multiple-myeloma
#7
Debajyoti Bhowmik, Xue Song, Michele Intorcia, Shia T Kent, Nianwen Shi
Objectives Within a median 1.2 years after patients have an initial diagnosis with multiple myeloma, up to 61% were diagnosed with renal impairment and 50% were diagnosed with chronic kidney disease. This study estimated economic burden associated with chronic kidney disease in multiple myeloma patients in the US. Methods In this retrospective cohort study, patients ≥18 years old with ≥1 inpatient or ≥ 2 outpatient multiple myeloma diagnoses between 1 January 2008 and 31 March 2015 were identified from MarketScan® Commercial and Medicare Supplemental Databases...
January 1, 2018: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/29660933/medical-comorbidity-in-alzheimer-s-disease-a-nested-case-control-study
#8
Jen-Hung Wang, Ya-Ju Wu, Boon Lead Tee, Raymond Y Lo
BACKGROUND: Little is known about the distribution of medical comorbidities in Alzheimer's disease (AD). OBJECTIVE: We aimed to describe the comorbidity pattern of AD in a nested case-control study. METHODS: Incident AD cases were identified by International Classification of Diseases codes in a random sample of 2 million individuals in Taiwan National Health Insurance program during 2001-2011. We further restricted cases to those treated with AD drugs of approved reimbursement...
April 11, 2018: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/29656808/injections-for-knee-osteoarthritis-corticosteroids-viscosupplementation-platelet-rich-plasma-and-autologous-stem-cells
#9
David M Levy, Kyle A Petersen, Margie Scalley Vaught, David R Christian, Brian J Cole
This article reviews the benefits of corticosteroid, viscosupplementation, platelet-rich plasma, and autologous mesenchymal stem cell injections for the treatment of patients with knee osteoarthritis. Integrating injections into both clinical and surgical practices is complicated given existing health insurance reimbursement policies. This review describes the outcomes associated with these interventions and appropriate methods of navigating the existing reimbursement pathways to help providers implement these treatments into their practices...
April 12, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/29628512/hot-news-sexually-transmitted-infections-on-the-rise-in-prep-users
#10
Pablo Barreiro
Pre-exposure prophylaxis (PrEP) with oral Truvada (tenofovir plus emtricitabine) is effective at preventing HIV infection in high-risk homosexual men. In the United States, PrEP was approved in 2012 and is reimbursed by Medicaid and the majority of private insurers. The situation is diverse and not uniform in the European Union, being PrEP more widely used in France than in the rest of countries. Concerns have been raised that PrEP use may be accompanied by the phenomena of risk compensation or behavioral disinhibition, whereby PrEP users' perception of decreased risk of HIV acquisition may lead them to engage in overall riskier sexual practices and increase their chances of acquiring sexually transmitted infections (STIs) (Blumenthal, et al...
January 2018: AIDS Reviews
https://www.readbyqxmd.com/read/29622136/american-college-of-radiology-accreditation-performance-metrics-reimbursement-and-economic-considerations-in-breast-mr-imaging
#11
REVIEW
Matthew F Covington, Catherine A Young, Catherine M Appleton
Accreditation through the American College of Radiology (ACR) Breast Magnetic Resonance Imaging Accreditation Program is necessary to qualify for reimbursement from Medicare and many private insurers and provides facilities with peer review on image acquisition and clinical quality. Adherence to ACR quality control and technical practice parameter guidelines for breast MR imaging and performance of a medical outcomes audit program will maintain high-quality imaging and facilitate accreditation. Economic factors likely to influence the practice of breast MR imaging include cost-effectiveness, competition with lower-cost breast-imaging modalities, and price transparency, all of which may lower the cost of MR imaging and allow for greater utilization...
May 2018: Magnetic Resonance Imaging Clinics of North America
https://www.readbyqxmd.com/read/29622078/update-of-mr-imaging-for-evaluation-of-lung-cancer
#12
REVIEW
Mario Ciliberto, Yuji Kishida, Shinichiro Seki, Takeshi Yoshikawa, Yoshiharu Ohno
Since MR imaging was introduced for the assessment of thoracic and lung diseases, various limitations have hindered its widespread adoption in clinical practice. Since 2000, various techniques have been developed that have demonstrated the usefulness of MR imaging for lung cancer evaluation, and it is now reimbursed by health insurance companies in many countries. This article reviews recent advances in lung MR imaging, focusing on its use for lung cancer evaluation, especially with regard to pulmonary nodule detection, pulmonary nodule and mass assessment, lung cancer staging and detection of recurrence, postoperative lung function prediction, and therapeutic response evaluation and prediction...
May 2018: Radiologic Clinics of North America
https://www.readbyqxmd.com/read/29615376/the-22-modifier-in-reimbursement-for-orthopedic-procedures-hip-arthroplasty-and-obesity-are-worth-the-effort
#13
Eric L Smith, David J Tybor, Hayley D Daniell, Laura A Naccarato, Mary E Pevear, Charles Cassidy
BACKGROUND: Orthopedic surgeons utilize the 22-modifier when billing for complex procedures under the American Medical Association's Current Procedural Terminology (CPT) for reasons such as excessive blood loss, anatomic abnormality, and morbid obesity, cases that would ideally be reimbursed at a higher rate to compensate for additional physician work and time. We investigated how the 22-modifier affects physician reimbursement in knee and hip arthroplasty. METHODS: We queried hospital billing data from 2009 to 2016, identifying all cases performed at our urban tertiary care orthopedic center for knee arthroplasty (CPT codes 27438, 27447, 27487, and 27488) and hip arthroplasty (CPT codes 27130, 27132, 27134, 27236)...
February 21, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29615363/trends-in-medicare-reimbursement-and-work-relative-value-unit-production-in-radiation-oncology
#14
Charles C Vu, Thomas B Lanni, Sirisha R Nandalur
PURPOSE: Medicare payments to individual physicians are released annually by the CMS. The purpose of this study is to analyze trends in Medicare reimbursement and work relative value unit (wRVU) production to radiation oncologists. MATERIALS AND METHODS: The Medicare Physician Supplier and Other Provider Public Use File and the CMS Physician Fee Schedule Relative Value Files (to calculate wRVUs) for the calendar years 2012 to 2015 were used in this analysis. Medicare reimbursement was aggregated for each calendar year...
March 31, 2018: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29615013/factors-influencing-government-insurance-scheme-beneficiary-acceptance-of-the-gatekeeper-policy-a-cross-sectional-study-in-wuhan-china
#15
Wenzhen Li, Dongming Wang, Yong Gan, Yanfeng Zhou, Yawen Chen, Jing Li, Naomiem Kkandawire, Sai Hu, Yan Qiao, Zuxun Lu
BACKGROUND: Gatekeeper policy, requiring a patient to visit a primary care provider first, and the patient needs to get his or her primary care provider's referral before seeing a specialist or going to a hospital, has been implemented in China for about ten years, and it is necessary to assess the patients' acceptance of gatekeeper policy and to explore the factors influencing patients' acceptance. METHODS: A cross-sectional study with 1162 respondents was conducted between July and September 2015 at four community health centers (CHCs) in Wuhan, China...
April 4, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29605836/structure-and-function-of-anticoagulation-clinics-in-the-united-states-an-ac-forum-membership-survey
#16
Geoffrey D Barnes, Eva Kline-Rogers, Christopher Graves, Eric Puroll, Xiaokui Gu, Kevin Townsend, Ellen McMahon, Terri Craig, James B Froehlich
Many anticoagulation clinics have adapted their services to provide care for patients taking direct oral anticoagulants (DOAC) in addition to traditional warfarin management. Anticoagulation clinic scope of service and operations in this transitional environment have not been well described in the literature. A survey was conducted of United States-based Anticoagulation Forum members to inquire about anticoagulation clinic structure, function, and services provided. Survey responses are reported using summary or non-parametric statistics, when appropriate...
March 31, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29602837/trends-in-initiation-of-direct-oral-anticoagulant-therapies-for-atrial-fibrillation-in-a-national-population-based-cross-sectional-study-in-the-french-health-insurance-databases
#17
Laetitia Huiart, Cyril Ferdynus, Christel Renoux, Amélie Beaugrand, Sophie Lafarge, Léa Bruneau, Samy Suissa, Olivier Maillard, Xavier Ranouil
OBJECTIVE: Unlike several other national health agencies, French health authorities recommended that the newer direct oral anticoagulant (DOAC) agents only be prescribed as second choice for the treatment of newly diagnosed non-valvular atrial fibrillation (NVAF), with vitamin K antagonists (VKA) remaining the first choice. We investigated the patterns of use of DOACs versus VKA in the treatment of NVAF in France over the first 5 years of DOAC availability. We also identified the changes in patient characteristics of those who initiated DOAC treatment over this time period...
March 30, 2018: BMJ Open
https://www.readbyqxmd.com/read/29602658/effects-of-the-affordable-care-act-on-payer-mix-and-physician-reimbursement-in-hand-surgery
#18
Ibrahim Khansa, Lara Khansa, Gregory D Pearson, Sonu A Jain
PURPOSE: To evaluate the effect of the Affordable Care Act (ACA) on the payer distribution and reimbursement rate for hand surgery at our institution. METHODS: We reviewed records of 4,257 patients who underwent hand surgery at our institution between January 2008 and June 2016; 2,601 patients underwent surgery before the implementation of the ACA, and 1,656 patients after. Type of procedure, insurance status, amount of money billed, and amount collected were recorded...
March 27, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29602185/stakeholder-perspectives-regarding-transfer-of-free-maternity-services-to-national-health-insurance-fund-in-kenya-implications-for-universal-health-coverage
#19
Timothy Abuya, Francis Obare, Dennis Matanda, Mardieh L Dennis, Ben Bellows
BACKGROUND: Kenya is developing strategies to finance health care through prepayment to achieve universal health coverage (UHC). Plans to transfer free maternity services (FMS) from the Ministry of Health to the National Health Insurance Fund (NHIF) are a step towards UHC. We examined views of health workers and women regarding the transition of FMS to NHIF to inform the process. METHODS: In-depth interviews among 14 facility-level managers and providers, 11 county-level managers, and 21 focus group discussions with women who gave birth before and after the introduction of FMS...
March 30, 2018: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/29601224/physical-therapists-perception-of-workplace-ethics-in-an-evolving-health-care-delivery-environment-a-cross-sectional-survey
#20
Roberto Cantu
Physical therapists are trained and obligated to deliver optimal health care and put patients first above all else. In the changing health-care environment, health-care organizations are grappling with controlling cost and increasing revenues. Moral distress may be created when physical therapists' desire to provide optimal care conflicts with their organization's goals to remain financially viable or profitable. Moral distress has been associated with low perception of ethical environment, professional burnout, and high turnover in organizations...
March 30, 2018: Physiotherapy Theory and Practice
keyword
keyword
119127
1
2
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"