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Nipun Sodhi, Benjamin Yao, Jared M Newman, Michael Jawad, Anton Khlopas, Assem A Sultan, Suela Lamaj, George A Beyer, Alyeesha B Wilhelm, Michael A Mont
INTRODUCTION: To determine the effort required to provide a service, the United States Medicare uses Relative Value Units (RVUs). Consequently, higher RVUs are assigned to the procedures or services that require more effort, which ultimately means the physician will be properly compensated for the additional effort required. In total ankle arthroplasty (TAA), revision cases usually are more technically challenging and require more effort than primary TAA. Therefore, the purpose of this study was to compare the: 1) RVUs; 2) length-of-surgery; 3) RVU per unit of time between primary and revision total ankle arthroplasty; and 4) the individualized idealized surgeon annual cost difference analysis...
December 22, 2017: Surgical Technology International
Hooman Molavi, Seyed Mohammad Ali Razavi, Reza Farhoosh
Native acorn starch had high purity and the granules were mainly elliptical and spherical with the mean diameter of 7.32 μm. Hydrothermal modifications slightly changed the morphology. The solubility, swelling properties and amylose leaching of acorn starch were mostly influenced by Heat-moisture treatment (HMT). XRD pattern of native starch (C-type) did not change on hydrothermal modifications, but native and annealing (ANN) modified starches showed the most crystallinity. DSC results showed that the gelatinization temperatures and enthalpy of native starch were 59...
April 15, 2018: Food Chemistry
Mark D Kovacs, Douglas H Sheafor, Paul G Thacker, Andrew D Hardie, Philip Costello
PURPOSE: In the era of value-based medicine, it will become increasingly important for radiologists to provide metrics that demonstrate their value beyond clinical productivity. In this article the authors describe their institution's development of an easy-to-use system for tracking value-added but non-relative value unit (RVU)-based activities. METHODS: Metrix Matrix is an efficient cloud-based system for tracking value-added work. A password-protected home page contains links to web-based forms created using Google Forms, with collected data populating Google Sheets spreadsheets...
December 23, 2017: Journal of the American College of Radiology: JACR
Jennifer Peterson, Nipun Sodhi, Anton Khlopas, Nicolas S Piuzzi, Jared M Newman, Assem A Sultan, Kim L Stearns, Michael A Mont
BACKGROUND: In total knee arthroplasty (TKA), revision cases are often technically more challenging, and require more operative time and aftercare than primary cases. These time and effort differences should therefore be appropriately compensated for when using the relative value unit (RVU) system. Therefore, the purpose of this study is to compare the mean (1) RVUs; (2) operative times; and (3) RVU/min; and (4) perform an individualized idealized surgeon annual cost difference analysis for primary vs revision TKA...
December 6, 2017: Journal of Arthroplasty
Carlo J Milani, Sean D Rundell, Jeffrey G Jarvik, Janna Friedly, Patrick J Heagerty, Andy Avins, David Nerenz, Laura S Gold, Judith A Turner, Thiru Annaswamy, Srdjan S Nedeljkovic, Pradeep Suri
STUDY DESIGN: Secondary analysis of the Back Pain Outcomes using Longitudinal Data (BOLD) cohort study. OBJECTIVE: To characterize associations of self-reported race/ethnicity with back pain (BP) patient-reported outcomes (PROs) and health care utilization among older adults with a new episode of care for BP. SUMMARY OF BACKGROUND DATA: No prior longitudinal studies have characterized associations between multiple race/ethnicity groups, and BP-related PROs and health care utilization in the US...
November 20, 2017: Spine
Umar L Ssonko, Florence I Muranga
The SEM of starch from five EAHB cultivars showed a mixture of irregular granule shapes with smooth surfaces. The starches' average diameter size ranged between 16.31 and 21.98 μm. The moisture, protein, and ash content of the starches were: 11.12%-11.84%, 0.1% and 0.23%-0.47% respectively. The amylose content of these starches was between 11% and 13%. The starches peak viscosity ranged between 488.42 and 558.66 RVU. The EAHB starches exhibited relatively low pasting temperatures (<75°C), a high peak viscosity (488...
November 2017: Food Science & Nutrition
Franklin Dexter, Craig Jarvie, Richard H Epstein
STUDY OBJECTIVE: Three observational studies at large teaching hospitals found that reducing turnover times resulted in the surgeons performing more cases. We sought to determine if these findings are generalizable to other hospitals, because, if so, reducing turnover times may be an important mechanism for hospitals to use for growing caseloads. DESIGN: Observational cohort study. SETTING: 116 hospitals in Iowa with inpatient or outpatient surgery from July 1, 2013 through June 30, 2015...
November 23, 2017: Journal of Clinical Anesthesia
Michael Breyer, Heather Farley, Greg Neyman, Wendy Nichols, John Kendall
BACKGROUND: Emergency physicians (EPs) are expected to deliver quality care while maintaining high levels of efficiency and productivity as measured by the relative value unit (RVU). OBJECTIVES: We sought to determine whether academic EPs with higher RVUs spend less time at the bedside than their colleagues. METHODS: This was a prospective, observational, cohort study. A 13-item task list was generated, pilot-tested, and placed onto a computerized tablet...
November 2017: Journal of Emergency Medicine
Kristine Bauer-Nilsen, Colin Hill, Daniel M Trifiletti, Bruce Libby, Donna H Lash, Melody Lain, Deborah Christodoulou, Constance Hodge, Timothy N Showalter
PURPOSE: To evaluate the delivery costs, using time-driven activity-based costing, and reimbursement for definitive radiation therapy for locally advanced cervical cancer. METHODS AND MATERIALS: Process maps were created to represent each step of the radiation treatment process and included personnel, equipment, and consumable supplies used to deliver care. Personnel were interviewed to estimate time involved to deliver care. Salary data, equipment purchasing information, and facilities costs were also obtained...
September 14, 2017: International Journal of Radiation Oncology, Biology, Physics
B Mawoyo, P Adebola, Abe S Gerrano, E O Amonsou
Amadumbe, known as taro is a traditional crop mainly grown for subsistence in Southern Africa. In this study, chemical composition and functional properties of nine amadumbe genotypes grown at two distinct locations were investigated. Carbohydrate contents (73-81%) of amadumbe genotypes were substantially high and varied with growth location. Protein contents ranged from 8-12% and fat was very low (less 1%) in all genotypes. Major minerals in flours were K, P, Mg and Ca, but these were present at varying levels depending on growth locations...
October 2017: Journal of Food Science and Technology
Nipun Sodhi, Nicolas S Piuzzi, Anton Khlopas, Jared M Newman, Thomas J Kryzak, Kim L Stearns, Michael A Mont
BACKGROUND: Relative value units (RVUs) are used to evaluate the effort required for providing a service to patients in order to determine compensation. Thus, more complicated cases, like revision arthroplasty cases, should yield a greater compensation. However, there are limited data comparing RVUs to the time required to complete the service. Therefore, the purpose of this study is to compare the (1) mean RVUs, (2) mean operative times, and (3) mean RVU/minute between primary and revision total hip arthroplasty (THA) and (4) perform an individualized idealized surgeon annual cost difference analysis...
September 19, 2017: Journal of Arthroplasty
Samira Rathnayake, Felix Nautsch, Thomas Robin Goodman, Howard P Forman, Gowthaman Gunabushanam
OBJECTIVE: The purpose of this study was to assess the importance of relative value unit (RVU) flow and other factors in report turnaround time (TAT) in emergency radiologic operations. MATERIALS AND METHODS: RVU flow was defined as the normalized (to 60 minutes) total work RVUs for studies performed in a given time interval of 30 minutes (RVU flow 30) or 60 minutes (RVU flow 60). Twenty-five weekday emergency radiology shifts each for four radiologists were randomly selected...
December 2017: AJR. American Journal of Roentgenology
Cuiping Yi, Yan Li, Junai Ping
The changes in sorghum [Sorghum bicolor (L.) Moench] proteins during germination and the resultant effects on the physicochemical properties of sorghum flour were studied using non-germinated grains as a control. Results showed that flour obtained from germinated sorghum grains had lower protein levels, higher protease levels, and higher free amino nitrogen content compared with the control. There was an increase in the albumin and globulin protein fractions and a decrease in kafirin. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis indicated that this decrease was the result of a decrease in γ-kafirins, while microscopy found that a continuous protein network was formed...
October 2017: Journal of Texture Studies
Franklin Dexter, Craig Jarvie, Richard H Epstein
STUDY OBJECTIVE: Percentage utilization of operating room (OR) time is not an appropriate endpoint for planning additional OR time for surgeons with high caseloads, and cannot be measured accurately for surgeons with low caseloads. Nonetheless, many OR directors claim that their hospitals make decisions based on individual surgeons' OR utilizations. This incongruity could be explained by the OR managers considering the earlier mathematical studies, performed using data from a few large teaching hospitals, as irrelevant to their hospitals...
August 24, 2017: Journal of Clinical Anesthesia
Shearwood McClelland, Jerry J Jaboin
INTRODUCTION: Medically refractory tremor treatment has evolved over the past half-century from intraoperative thalamotomy to deep brain stimulation (DBS) of the thalamic ventral intermediate nucleus (VIM). Within the past 15years, unilateral radiosurgical VIM thalamotomy has emerged as a comparably efficacious treatment modality. METHODS: An extensive literature search of VIM DBS series was performed; the total cost of VIM DBS was calculated from hospitals geographically representative of the entire United States using current procedural terminology and work relative value unit (RVU) codes...
August 14, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Jan Löhler, F Gräbner, B Wollenberg, P Schlattmann, R Schönweiler
Subjective hearing loss in hearing-impaired patients can be assessed by inventory questionnaires. The abbreviated profile of hearing aid benefit (APHAB) measures subjective hearing loss in four typical hearing situations (subscales). It is used to fit hearing aids in patients with statutory insurance in Germany. In addition, the unaided APHAB (APHABu) can be used as a primary diagnostic instrument in audiology. There are no published data regarding the sensitivity and specificity of the unaided APHABu. Therefore, we investigated these parameters for detecting hearing loss of at least 25 dB at any frequency between 0...
July 29, 2017: European Archives of Oto-rhino-laryngology
Taylor B Turner, Sarah E Dilley, Haller J Smith, Warner K Huh, Susan C Modesitt, Stephen L Rose, Laurel W Rice, Jeffrey M Fowler, J Michael Straughn
OBJECTIVE: Physician burnout is associated with mental illness, alcohol abuse, and job dissatisfaction. Our objective was to estimate the impact of burnout on productivity of gynecologic oncologists during the first half of their career. METHODS: A decision model evaluated the impact of burnout on total relative value (RVU) production during the first 15years of practice for gynecologic oncologists entering the workforce from 2011 to 2015. The SGO practice survey provided physician demographics and mean annual RVUs...
September 2017: Gynecologic Oncology
Daniel Cloetingh, Rodney A Schmidt, Christina S Kong
Objectives: Pathologist workload in the United States has traditionally been measured by relative value units (RVUs), which is often criticized for providing an inaccurate estimate of actual work. This study compares three methods for measuring workload. Methods: Surgical pathology and cytopathology workload for 1 representative month at Stanford Health Care was assessed using three different methods: RVUs, Royal College of Pathologists (RCP) point system, and University of Washington-Seattle (UW) slide count method...
July 1, 2017: American Journal of Clinical Pathology
Andrew B Rosenkrantz, Ezequiel Silva, C Matthew Hawkins
PURPOSE: In 2006, the AMA/Specialty Society Relative Value Scale Update Committee (RUC) introduced ongoing relativity screens to identify potentially misvalued medical services for payment adjustments. We assess the impact of these screens upon the valuation of noninvasive diagnostic radiology services. METHODS: Data regarding relativity screens and relative value unit (RVU) changes were obtained from the 2016 AMA Relativity Assessment Status Report. All global codes in the 2016 Medicare Physician Fee Schedule with associated work RVUs were classified as noninvasive diagnostic radiology services versus remaining services...
November 2017: Journal of the American College of Radiology: JACR
Joseph H Conduff, Daniel H Coelho
HYPOTHESIS: Medicaid reimbursement rates for cochlear implants and related services fall short of the federal benchmark set by Medicare. BACKGROUND: The financial hardships of cochlear implant centers around the United States may be a repercussion of poor Medicaid reimbursement. In time, these reimbursement discrepancies could force additional Otolaryngologists and cochlear implant centers to not provide these crucial services due to financial limitations. METHODS: Based on Medicare (MCR) claims data, current procedural terminology (CPT) codes used for cochlear implantation and related services were selected...
August 2017: Otology & Neurotology
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