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Physician reimbursement

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https://www.readbyqxmd.com/read/29906211/the-state-of-oncology-practice-in-america-2018-results-of-the-asco-practice-census-survey
#1
M Kelsey Kirkwood, Amy Hanley, Suanna S Bruinooge, Elizabeth Garrett-Mayer, Laura A Levit, Caroline Schenkel, Jerome E Seid, Blase N Polite, Richard L Schilsky
PURPOSE: To describe the US hematology and medical oncology practice landscape and to report findings of the sixth annual ASCO Oncology Practice Census survey. PARTICIPANTS AND METHODS: ASCO used Medicare Physician Compare data to characterize oncology practices in the United States. Practice size, number of care sites, and geographic distribution were determined. Trends in the number and size of practices from 2013 to 2017 were examined. All US oncology practices were targeted for the survey; survey responses were linked to the practices identified from Physician Compare to augment results and assess generalizability...
June 15, 2018: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29891265/cost-effective-management-of-stenosing-tenosynovitis
#2
Andrea Halim, Andrew D Sobel, Adam E M Eltorai, Kaveh P Mansuripur, Arnold-Peter C Weiss
PURPOSE: Stenosing tenosynovitis (STS) is a common condition treated by hand surgeons. Limited evidence exists to support the nonsurgical management of STS. The purpose of this study was to prospectively evaluate a cohort of patients with STS, and to determine the strategy for treating patients with this condition that is most cost effective in terms of dollars reimbursed by payers. METHODS: Prospective data were collected on patients diagnosed with STS between March 2014 and September 2014...
June 8, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29889752/three-lymphadenectomy-strategies-in-low-risk-endometrial-carcinoma-a-cost-effectiveness-analysis
#3
Rudy S Suidan, Charlotte C Sun, Scott B Cantor, Andrea Mariani, Pamela T Soliman, Shannon N Westin, Karen H Lu, Sharon H Giordano, Larissa A Meyer
OBJECTIVE: To evaluate the cost-utility of three lymphadenectomy strategies in the management of low-risk endometrial carcinoma. METHODS: A decision analysis model compared three lymphadenectomy strategies in women undergoing minimally invasive surgery for low-risk endometrial carcinoma: 1) routine lymphadenectomy in all patients, 2) selective lymphadenectomy based on intraoperative frozen section criteria, and 3) sentinel lymph node mapping. Costs and outcomes were obtained from published literature and Medicare reimbursement rates...
June 6, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29876774/rapid-antigen-test-use-for-the-management-of-group-a-streptococcal-pharyngitis-in-community-pharmacies
#4
Béatrice Demoré, Gianpiero Tebano, Julien Gravoulet, Christophe Wilcke, Eric Ruspini, Jacques Birgé, Jean-Marc Boivin, Sandrine Hénard, Annick Dieterling, Lidiana Munerol, Julie Husson, Christian Rabaud, Céline Pulcini, Sophie Malblanc
Despite group A streptococci being an infrequent cause of pharyngitis in adult outpatients, sore throat remains a common indication for antibiotic prescription. This prospective multicentre non-randomised study describes a community pharmacy-based antimicrobial stewardship intervention consisting in the implementation of rapid antigen testing (RAT) for the management of adults with sore throat. Trained pharmacists triaged patients presenting with symptoms of pharyngitis using the modified Centor score. Those at risk for streptococcal infection were tested with RAT...
June 6, 2018: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29872768/provider-insight-on-surmounting-specialty-practice-challenges-to-improve-tdap-immunization-rates-among-pregnant-women
#5
Arpita Mehrotra, Allison Kennedy Fisher, Jennifer Mullen, Leslie Rodriguez, Angela J Jiles, Alison P Albert, Laura A Randall, Paula M Frew
Background: Pertussis, or "whooping cough," is an acute, contagious pulmonary disease that, despite being vaccine-preventable, has become an increasingly widespread problem in the United States. As a result, the Advisory Committee on Immunization Practices and American College of Obstetricians and Gynecologists updated recommendations stating clinicians should give a Tdap dose during every pregnancy, preferably at 27-36 weeks. Despite this recommendation, reported Tdap vaccine receipt rates during pregnancy vary from 16-61%, and previous studies have shown that clinician recommendation and vaccine administration are strongly associated with vaccine uptake among pregnant women...
May 2018: Heliyon
https://www.readbyqxmd.com/read/29859886/review-of-transitional-care-management-and-chronic-care-management-codes-for-pulmonologists
#6
REVIEW
Veronica Rivera, Linda V DeCherrie, Audrey Chun
Patients with advanced respiratory illness are often hospitalized, requiring close follow up after discharge and also requiring care coordination outside of traditional face-to-face outpatient visits. Primary Care providers and specialists often provide services outside of outpatient visits that have not been captured and reimbursed with traditional billing evaluation and management codes (E/M). Within the last five years, the Centers for Medicare and Medicaid (CMS) added new codes to the Medicare Physician Fee Schedule that reimburse for care coordination services not paid for by traditional evaluation and management codes (E/M)...
May 31, 2018: Chest
https://www.readbyqxmd.com/read/29845936/home-haemodialysis-in-the-netherlands-state-of-the-art
#7
A A Bonenkamp, M K van Gelder, A C Abrahams, F T J Boereboom, T Cornelis, A J Luik, A Özyilmaz, F M van der Sande, A van Eck van der Sluijs, K G F Gerritsen, B C van Jaarsveld
Home haemodialysis (HHD) has gained popularity in recent years, due to improved clinical outcomes associated with frequent or prolonged haemodialysis sessions, best achievable at home. However, several barriers to HHD are perceived by the physician and patient, among which lack of experience and education, logistic difficulties and reimbursement issues seem to be the most important ones. HHD, in particular when performed with intensified frequency or duration, is associated with improved quality of life, blood pressure control and survival...
May 2018: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/29804824/the-2017-american-college-of-cardiology-american-heart-association-hypertension-guideline-and-opportunities-for-community-pharmacists
#8
Dave L Dixon, Teresa M Salgado, Lauren M Caldas, Benjamin W Van Tassell, Evan M Sisson
OBJECTIVES: To initiate a call to action for community pharmacists to maximize the opportunities to improve the management of hypertension (HTN) in light of the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) HTN guideline. SUMMARY: In November 2017, the ACC and the AHA, along with 9 other professional organizations, released a comprehensive guideline on the prevention, detection, evaluation, and management of high blood pressure (BP)...
May 24, 2018: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/29797314/physicians-views-on-advance-care-planning-and-end-of-life-care-conversations
#9
Terry Fulmer, Marcus Escobedo, Amy Berman, Mary Jane Koren, Sandra Hernández, Angela Hult
OBJECTIVES: To evaluate physicians' views on advance care planning, goals of care, and end-of-life conversations. DESIGN: Random sample telephone survey. SETTING: United States. PARTICIPANTS: Physicians (primary care specialists; pulmonology, cardiology, oncology subspecialists) actively practicing medicine and regularly seeing patients aged 65 and older (N=736; 81% male, 75% white, 66% aged ≥50. MEASUREMENTS: A 37-item telephone survey constructed by a professional polling group with national expert oversight measured attitudes and perceptions of barriers and facilitators to advance care planning...
May 23, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29795647/estimating-the-cost-effectiveness-of-a-sequential-pneumococcal-vaccination-program-for-adults-in-germany
#10
Ulrike Kuchenbecker, Daniela Chase, Anika Reichert, Julia Schiffner-Rohe, Mark Atwood
INTRODUCTION: In Germany, a 23-valent polysaccharide pneumococcal vaccine (PPSV23) is recommended for elderly (60+) and patients 16+ with chronic diseases not associated with immune suppression. For all other patients at risk, sequential immunization with a 13-valent pneumococcal conjugate vaccine (PCV13) first, followed by PPSV23 is recommended. Repeated vaccination with PPSV23 is recommended every 6 years after individual assessment by the physician. This was adopted into the vaccination directive with binding reimbursement and funding...
2018: PloS One
https://www.readbyqxmd.com/read/29794522/medicaid-innovations-and-the-role-of-academic-health-centers
#11
Sheldon M Retchin, Wendy Yi Xu
Although they represent less than 8% of all U.S. hospitals, academic health centers (AHCs) deliver almost 40% of the inpatient care for Medicaid beneficiaries. However, because of low Medicaid reimbursement rates, AHCs have had to rely on supplemental funding sources, such as disproportionate share hospital (DSH) payments and upper payment limit (UPL) payments. Recent legislative efforts and changes to payment structures have made these sources vulnerable to severe reductions. For instance, DSH payments are scheduled to be cut by $8 billion by 2021, and UPL payments are a diminishing resource for many states because the program is based on a fee-for-service model and most states are moving to managed care...
May 22, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29794207/oxygen-therapy-in-copd
#12
Richard D Branson
Long-term oxygen therapy (LTOT) at home has been demonstrated to improve survival in patients with COPD and severe resting hypoxemia. Support for LTOT is based on 2 landmark trials published nearly 4 decades ago. These results form the basis for reimbursement and prescription of LTOT to this day. Recent work has demonstrated no outcome benefit of LTOT in stable COPD patients with moderate desaturation at rest or during activity. Oxygen therapy during activity and exercise has been shown to alleviate symptoms and maintain arterial oxygen saturation, but not improve long-term outcomes...
June 2018: Respiratory Care
https://www.readbyqxmd.com/read/29780836/defining-platelet-rich-plasma-usage-by-team-physicians-in-elite-athletes
#13
David E Kantrowitz, Ajay S Padaki, Christopher S Ahmad, T Sean Lynch
Background: The indications for the use of platelet-rich plasma (PRP) are vaguely defined despite the frequency of its use as a treatment for athletes. While select studies have advocated for its efficacy, the majority of orthopaedic research conducted on the topic has been equivocal. Purpose: To define the use of PRP in elite athletes by team physicians from professional sports leagues. Study Design: Cross-sectional study. Methods: A survey assessing treatment timing, usage patterns, indications, and complications was generated by fellowship-trained sports medicine orthopaedic surgeons...
April 2018: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29779547/policy-pathways-to-address-provider-workforce-barriers-to-buprenorphine-treatment
#14
Rebecca L Haffajee, Amy S B Bohnert, Pooja A Lagisetty
At least 2.3 million people in the U.S. have an opioid use disorder, less than 40% of whom receive evidence-based treatment. Buprenorphine used as part of medication-assisted treatment has high potential to address this gap because of its approval for use in non-specialty outpatient settings, effectiveness at promoting abstinence, and cost effectiveness. However, less than 4% of licensed physicians are approved to prescribe buprenorphine for opioid use disorder, and approximately 47% of counties lack a buprenorphine-waivered physician...
June 2018: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29779544/prescribing-practices-of-rural-physicians-waivered-to-prescribe-buprenorphine
#15
C Holly A Andrilla, Cynthia Coulthard, Davis G Patterson
INTRODUCTION: Opioid use disorder is a serious public health burden, especially throughout rural America. Although efforts have been made to increase the availability of buprenorphine (an office-based medication-assisted treatment), more than 60% of rural counties in the U.S. lack a physician with a Drug Enforcement Administration waiver to prescribe it. METHODS: This study surveyed all rural physicians with a Drug Enforcement Administration waiver in 2016 to prescribe buprenorphine for opioid use disorder in the U...
June 2018: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29769813/paediatric-vision-screening-in-the-primary-care-setting-in-ontario
#16
Tran D Le, Rana Arham Raashid, Linda Colpa, Jason Noble, Asim Ali, Agnes Wong
Objectives: Early intervention is critical to prevent treatable causes of vision loss in children. The objectives of the current study are: (1) to assess how well primary care physicians in Ontario follow the vision screening guidelines for children as recommended by the Canadian Paediatric Society and the Rourke Baby Record and (2) to identify barriers to vision screening in the primary care setting. Design: Cross-sectional survey. Methods: A 19-question survey was mailed out to 1000 randomly selected family physicians (family MDs), 1000 general practitioners (GPs) and 1000 paediatricians in Ontario as listed in the 2013 Canadian Medical Directory...
May 2018: Paediatrics & Child Health
https://www.readbyqxmd.com/read/29754981/dialysis-patients-undergoing-total-knee-arthroplasty-have-significantly-increased-odds-of-perioperative-adverse-events-independent-of-demographic-and-comorbidity-factors
#17
Taylor D Ottesen, Cheryl K Zogg, Monique S Haynes, Rohil Malpani, Kirthi S Bellamkonda, Jonathan N Grauer
BACKGROUND: The prevalence of dialysis-dependent patients is growing, and an increasing number of these patients are being considered for total knee arthroplasty (TKA). Studies assessing the preoperative risk associated with TKA in this population are limited to institutional cohorts with small sample sizes or national inpatient databases that lack follow-up data. METHODS: The 2006-2015 National Surgical Quality Improvement Program databases were queried for adult patients undergoing elective TKA...
April 19, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29753519/state-of-the-national-emergency-department-workforce-who-provides-care-where
#18
M Kennedy Hall, Kevin Burns, Michael Carius, Mitchel Erickson, Jane Hall, Arjun Venkatesh
STUDY OBJECTIVE: We describe the current US emergency medicine workforce in terms of clinician type and examine rural and urban emergency medicine workforce differences. METHODS: Using the 2014 Medicare Public Use Files, we performed a cross-sectional study of all clinicians receiving reimbursement for evaluation and management (E/M) services (levels 1 to 5) to Medicare fee-for-service Part B beneficiaries in the emergency department. Providers were defined as emergency physicians, nonemergency physicians, or advanced practice providers, corresponding with the Medicare Public Use Files data set...
May 9, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29751979/principles-of-billing-for-diagnostic-ultrasound-in-the-office-and-operating-room
#19
REVIEW
Beatrice L Grasu, Bruce S Wolock, Matthew D Sedgley, Michael S Murphy
Ultrasound is becoming more prevalent as physicians gain comfort in its diagnostic and therapeutic uses. It allows for both static and dynamic evaluation of conditions and assists in therapeutic injections of joints and tendons. Proper technique is necessary for successful use of this modality. Appropriate coding for physician reimbursement is required. We discuss common wrist and hand pathology for which ultrasound may be useful as an adjunct to diagnosis and treatment and provide an overview of technique and reimbursement codes when using ultrasound in a variety of situations...
May 8, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29735302/a-physician-led-initiative-to-improve-clinical-documentation-results-in-improved-health-care-documentation-case-mix-index-and-increased-contribution-margin
#20
Francesco A Aiello, Dejah R Judelson, Jonathan M Durgin, Danielle R Doucet, Jessica P Simons, Dawn M Durocher, Julie M Flahive, Andres Schanzer
INTRODUCTION: Clinical documentation is the key determinant of inpatient acuity of illness and payer reimbursement. Every inpatient hospitalization is placed into a diagnosis related group with a relative value based on documented procedures, conditions, comorbidities and complications. The Case Mix Index (CMI) is an average of these diagnosis related groups and directly impacts physician profiling, medical center profiling, reimbursement, and quality reporting. We hypothesize that a focused, physician-led initiative to improve clinical documentation of vascular surgery inpatients results in increased CMI and contribution margin...
May 4, 2018: Journal of Vascular Surgery
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