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https://www.readbyqxmd.com/read/28339001/centers-for-medicare-medicaid-services-comprehensive-care-for-joint-replacement-the-present-and-future-for-orthopedic-surgeons
#1
Craig A Hogan, Melanie F Sandoval, Lauren M Uhler
The primary aim of this article is to describe the structure and challenges of Medicare and Medicaid reimbursement for a total hip or knee arthroplasty within the context of the Comprehensive Care for Joint Replacement model. The secondary aims are to identify potential challenges for reimbursement and solutions to overcome challenges for the orthopedic surgeon, and to describe and compare the current and projected reimbursement structures for total arthroplasty procedures. Final decisions on reimbursement for total arthroplasty as outlined by the Centers for Medicare & Medicaid Services are reviewed...
March 1, 2017: Orthopedics
https://www.readbyqxmd.com/read/28338572/the-drivers-of-medicare-reimbursement-for-thoracolumbar-fusion-an-analysis-of-data-from-the-centers-for-medicare-and-medicaid-services
#2
Krishn Khanna, Eric M Padegimas, Benjamin Zmistowski, Michael Howley, Kushagra Vema
STUDY DESIGN: Retrospective observational OBJECTIVE.: The purpose of this study is to examine the variation in Thoracolumbar Fusion (TLF) payment and determine the drivers of this variation. SUMMARY OF BACKGROUND DATA: As healthcare spending continues to increase, variation in surgical procedures reimbursements has come under more scrutiny. TLF is an example of a high-cost, proven-benefit procedure that is often the focus of Centers for Medicare and Medicaid Services (CMS) administrators...
March 23, 2017: Spine
https://www.readbyqxmd.com/read/28338229/response-to-endurance-exercise-training-in-older-adults-with-heart-failure-with-preserved-or-reduced-ejection-fraction
#3
Ambarish Pandey, Dalane W Kitzman, Peter Brubaker, Mark J Haykowsky, Timothy Morgan, J Thomas Becton, Jarett D Berry
OBJECTIVES: To systematically examine the relative magnitude and predictors of responses to exercise training in older adult with heart failure (HF) with reduced ejection fraction (HFrEF), and preserved EF (HFpEF). DESIGN: Secondary analysis of a randomized controlled trial. SETTING: Outpatient cardiac rehabilitation program. PARTICIPANTS: Individuals with HF (24 HFrEF, 24 HFpEF) who underwent supervised exercise training...
March 24, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28337732/medicare-reimbursement-and-orthopedic-surgery-past-present-and-future
#4
REVIEW
R Carter Clement, Suneel B Bhat, Meredith E Clement, James C Krieg
PURPOSE OF REVIEW: This paper reviews the history and structure of Medicare reimbursement with a focus on aspects relevant to the field of orthopedic surgery. Namely, this includes Parts A and B, with particular attention paid to the origins of Diagnosis Related Groups (DRG) and the physician fee schedule, respectively. We then review newer policies affecting orthopedic surgeons. RECENT FINDINGS: Recent Medicare reforms relevant to our field include readmission penalties, the evolution of bundled payments including the mandatory Comprehensive Care for Joint Replacement (CJR) and Surgical Hip and Femur Fracture Treatment (SHFFT) programs, and the new mandatory Merit-based Incentive Payment System (MIPS) pay-for-performance program...
March 23, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28337689/managing-chronic-pain-in-primary-care-it-really-does-take-a-village
#5
Karen Seal, William Becker, Jennifer Tighe, Yongmei Li, Tessa Rife
Some healthcare systems are relieving primary care providers (PCPs) of "the burden" of managing chronic pain and opioid prescribing, instead offloading chronic pain management to pain specialists. Last year the Centers for Disease Control and Prevention recommended a biopsychosocial approach to pain management that discourages opioid use and promotes exercise therapy, cognitive behavioral therapy and non-opioid medications as first-line patient-centered, multi-modal treatments best delivered by an interdisciplinary team...
March 23, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28336485/low-dose-computed-tomography-for-lung-cancer-screening-clinical-and-coding-considerations
#6
REVIEW
Yiwey Shieh, Martin Bohnenkamp
Lung cancer screening with low-dose computed tomography (LDCT) was shown to reduce lung cancer mortality in the National Lung Screening Trial, a large randomized-controlled trial of high-risk current and former smokers. Despite ongoing uncertainty over the effectiveness of LDCT in the real-world setting, the Centers for Medicare and Medicaid Services (CMS) decided to cover LDCT as a preventive service. As part of its national coverage determination, CMS set forth a series of requirements for reimbursement of LDCT, including a counseling and shared decision-making visit prior to a LDCT being ordered...
March 21, 2017: Chest
https://www.readbyqxmd.com/read/28335754/the-structural-and-health-policy-environment-for-delivering-integrated-hiv-and-substance-use-disorder-treatments-in-puerto-rico
#7
Jared A Leff, Diana Hernández, Paul A Teixeira, Pedro C Castellón, Daniel J Feaster, Allan E Rodriguez, Jorge L Santana-Bagur, Sandra Miranda De León, José Vargas Vidot, Lisa R Metsch, Bruce R Schackman
BACKGROUND: HIV prevalence in Puerto Rico is nearly twice that of the mainland United States, a level that was substantially fueled by injection drug use. Puerto Rico has a longstanding history of health provision by the public sector that directly affects how HIV and substance use disorder (SUD) treatment services are provided and funded. As part of pre-implementation research for a randomized trial of a community-level intervention to enhance HIV care access for substance users in San Juan, Puerto Rico, we sought to understand the structural and health policy environment for providing HIV and SUD treatments...
March 23, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28335636/utility-values-associated-with-advanced-or-metastatic-non-small-cell-lung-cancer-data-needs-for-economic-modeling
#8
Jacqueline Brown, Keziah Cook, Kelly Adamski, Jocelyn Lau, Danielle Bargo, Sarah Breen, Anita Chawla
Cost-effectiveness analyses often inform healthcare reimbursement decisions. The preferred measure of effectiveness is the quality adjusted life year (QALY) gained, where the quality of life adjustment is measured in terms of utility. Areas Covered: We assessed the availability and variation of utility values for health states associated with advanced or metastatic non-small cell lung cancer (NSCLC) to identify values appropriate for cost-effectiveness models assessing alternative treatments. Our systematic search of six electronic databases (January 2000 to August 2015) found the current literature to be sparse in terms of utility values associated with NSCLC, identifying 27 studies...
March 24, 2017: Expert Review of Pharmacoeconomics & Outcomes Research
https://www.readbyqxmd.com/read/28334244/cognitive-screening-tests-versus-comprehensive-neuropsychological-test-batteries-a-national-academy-of-neuropsychology-education-paper%C3%A2
#9
Tresa M Roebuck-Spencer, Tannahill Glen, Antonio E Puente, Robert L Denney, Ronald M Ruff, Gayle Hostetter, Kevin J Bianchini
The American Medical Association Current Procedural Panel developed a new billing code making behavioral health screening a reimbursable healthcare service. The use of computerized testing as a means for cognitive screening and brief cognitive testing is increasing at a rapid rate. The purpose of this education paper is to provide information to clinicians, healthcare administrators, and policy developers about the purpose, strengths, and limitations of cognitive screening tests versus comprehensive neuropsychological evaluations...
March 10, 2017: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
https://www.readbyqxmd.com/read/28333819/practice-bulletin-no-177-obstetric-analgesia-and-anesthesia
#10
(no author information available yet)
Labor causes severe pain for many women. There is no other circumstance in which it is considered acceptable for an individual to experience untreated severe pain that is amenable to safe intervention while the individual is under a physician's care. Many women desire pain management during labor and delivery, and there are many medical indications for analgesia and anesthesia during labor and delivery. In the absence of a medical contraindication, maternal request is a sufficient medical indication for pain relief during labor...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28333811/practice-bulletin-no-177-summary-obstetric-analgesia-and-anesthesia
#11
(no author information available yet)
Labor causes severe pain for many women. There is no other circumstance in which it is considered acceptable for an individual to experience untreated severe pain that is amenable to safe intervention while the individual is under a physician's care. Many women desire pain management during labor and delivery, and there are many medical indications for analgesia and anesthesia during labor and delivery. In the absence of a medical contraindication, maternal request is a sufficient medical indication for pain relief during labor...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28333786/the-bundled-care-disruption
#12
Carol Anne Boston-Fleischhauer
The new administration and Congress will wrestle with the Affordable Care Act and options. In the meantime, several reimbursement programs designed to disrupt current approaches to patient care delivery continue, including the Centers for Medicare & Medicaid Services bundled payment program. Chief nurse executives must prepare to advance processes and care models that align with bundled payments and the broader ambition to eliminate care variation.
April 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/28333337/tubal-anastomosis-after-previous-sterilization-a-systematic-review
#13
Jacoba A H van Seeters, Su Jen Chua, Ben W J Mol, Carolien A M Koks
BACKGROUND: Female sterilization is one of the most common contraceptive methods. A small number of women, however, opt for reversal of sterilization procedures after they experience regret. Procedures can be performed by laparotomy or laparoscopy, with or without robotic assistance. Another commonly utilized alternative is IVF. The choice between surgery and IVF is often influenced by reimbursement politics for that particular geographic location. OBJECTIVE AND RATIONALE: We evaluated the fertility outcomes of different surgical methods available for the reversal of female sterilization, compared these to IVF and assessed the prognostic factors for success...
February 22, 2017: Human Reproduction Update
https://www.readbyqxmd.com/read/28332925/implications-of-clinical-documentation-in-accuracy-a-pilot-study-among-general-surgery-residents
#14
Andrea Garcia, Lee Revere, Sherene Sharath, Panos Kougias
Accurate and reliable medical records are necessary for assessing, improving, and reimbursing healthcare services. Clear and concise physician documentation is essential to assuring accurate and reliable medical records. Yet, prior literature reveals surgery residents do not receive adequate, beneficial education on medical record documentation and coding. This is concerning because the evaluation of and reimbursement for healthcare service delivery relies on the physician's ability to produce appropriate medical records, which then get translated into billable codes...
March 23, 2017: Hospital Topics
https://www.readbyqxmd.com/read/28332179/reducing-radiation-to-patients-and-improving-image-quality-in-a-real-world-nuclear-cardiology-laboratory
#15
Stephen A Bloom, Karen Meyers
In part because of aging equipment and reduced reimbursement for imaging services in the last several years, nuclear cardiologists who remain in private practice face challenges in maintaining high quality and in reducing radiation exposure to patients. We review patient-centered approaches and affordable software solutions employed in our practice combined with supine-prone myocardial perfusion imaging to achieve increased interpretive confidence with reduced radiation exposure to patients.
March 22, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28330731/diabetes-self-management-education-and-medical-nutrition-therapy-improve-patient-outcomes-a-pilot-study-documenting-the-efficacy-of-registered-dietitian-nutritionist-interventions-through-retrospective-chart-review
#16
Patricia Z Marincic, Amie Hardin, Maria V Salazar, Susan Scott, Shirley X Fan, Philippe R Gaillard
BACKGROUND: Diabetes self-management education (DSME) and medical nutrition therapy (MNT) improve patient outcomes; poor reimbursement limits access to care. OBJECTIVE: Our aim was to develop methodology for tracking patient outcomes subsequent to registered dietitian nutritionist interventions, document outcomes for patients with type 2 diabetes attending an American Diabetes Association-recognized program, and obtain outcome data to support reimbursement and public policy initiatives to improve patient access to DSME and MNT...
March 16, 2017: Journal of the Academy of Nutrition and Dietetics
https://www.readbyqxmd.com/read/28329352/costs-and-consequences-of-early-hospital-discharge-after-major-inpatient-surgery-in-older-adults
#17
Scott E Regenbogen, Anne H Cain-Nielsen, Edward C Norton, Lena M Chen, John D Birkmeyer, Jonathan S Skinner
Importance: As prospective payment transitions to bundled reimbursement, many US hospitals are implementing protocols to shorten hospitalization after major surgery. These efforts could have unintended consequences and increase overall surgical episode spending if they induce more frequent postdischarge care use or readmissions. Objective: To evaluate the association between early postoperative discharge practices and overall surgical episode spending and expenditures for postdischarge care use and readmissions...
March 22, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28328245/-performance-indicators-of-maxillofacial-surgery-inpatient-departments
#18
Gyula Marada, Ákos Nagy, Andor Sebestyén, Antal Zemplényi, Márta Radnai, Imre Boncz
INTRODUCTION: In Hungary, the number and structure of the maxillofacial surgery departments underwent significant changes in recent decades. AIM: The aim of our study was to present the actual performance indicators of maxillofacial inpatient departments and based on the available data to compare the departments. METHOD: The study was based on the number of beds founded by the National Health Insurance Fund. Performance data were supplied by the National Health Insurance Fund Administration...
March 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28324327/lumbar-disc-replacement-surgery-successes-and-obstacles-to-widespread-adoption
#19
REVIEW
Stephan N Salzmann, Nicolas Plais, Jennifer Shue, Federico P Girardi
PURPOSE OF REVIEW: Lumbar disc replacement has been a surgical alternative to fusion surgery for the treatment of lumbar degenerative disc disease (DDD) for many years. Despite enthusiasm after the approval of the first devices, implantation rates have remained low, especially in the USA. The goal of this review is to provide a general overview of lumbar disc replacement in order to comprehend the successes and obstacles to widespread adoption. RECENT FINDINGS: Although a large amount of evidence-based data including satisfactory long-term results is available, implantation rates in the USA have not increased in the last decade...
March 21, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28323791/obesity-is-associated-with-high-peri-operative-complications-among-surgically-treated-intertrochanteric-fracture-of-the-femur
#20
Harish Kempegowda, Raveesh Richard, Amrut Borade, Akhil Tawari, Graham Jove, Michael Suk, Abby Howenstein, Erik N Kubiak, Vanessa Rojas Sotomayor, Kenneth Koval, Frank A Liporace, Nirmal Tejwani, Daniel S Horwitz
OBJECTIVES: The purpose of this study was to document the complications among obese patients who underwent surgical fixation for intertrochanteric femur fractures and to compare with non-obese patients. DESIGN: Retrospective cohort study SETTING:: Four level I trauma centers. PATIENTS: 1078 intertrochanteric femur fracture patients INTERVENTIONS:: None MAIN OUTCOME MEASURES:: Patient and fracture characteristics, surgical duration, surgical delay intra-operative and post-operative complications, inpatient mortality and length of stay...
March 8, 2017: Journal of Orthopaedic Trauma
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