Posts Tagged ‘Medicare’
PET Imaging Advancements For Alzheimer’s Disease With F18
CMS has set January 30, 2013 as the date to discuss and review the evidence on the potential benefits of [...] Read More »
More Proposed Reimbursement Cuts for Radiation Oncology
It seems that every year the Centers for Medicare & Medicaid Services (CMS) finds additional ways to cut reimbursement for [...] Read More »
Femtosecond Lasers: Next Generation in Cataract Surgery
Femtosecond lasers enable surgeons to perform a more accurate capsulotomy when removing a patient’s lens during a cataract procedure. Traditionally [...] Read More »
Finally, a Balloon Sinuplasty Payment Code
Since January 1, 2011, Balloon Sinuplasty has had its own unique set of reimbursement codes. Under the new code, APC 75, the payment level for Medicare patients averages $2,144, enough to cover the estimated $1,200 in disposable costs. Read More »
Pulmonary Rehab: Proven Outcomes and a 25% Payment Increase
Pulmonary rehab is similar to cardiac programs in that they train patients on how to manage their disease to reduce their symptoms. Clinical trials have shown that pulmonary rehabilitation can significantly reduce hospital admissions by up to 35% and reduce mortality by 29%. Another study indicated that after three months, the risk of readmission is lowered by 50% for COPD patients that have undergone pulmonary rehab. Considering that each year, there are over 672,000 discharges for COPD, pulmonary rehab should make a big impact on just about every hospital. Read More »
Oncology: Proton Beam Therapy Reimbursement Takes a Leap
Proton therapy's benefits lie in its ability to destroy cancerous cells with sub-millimeter accuracy. In a 2009 review, when comparing radiation doses to a retinoblastoma target, IMRT resulted in 96% coverage; proton beam therapy was able to cover 100% of the target. The same study underlined that an advantage of proton beam therapy is that is does not harm healthy tissue. Proton beam therapy resulted in only 10% of the dose going to healthy tissue. In comparison, 25% dose going to healthy tissue using 3D-CRT and of 69% using IMRT. Read More »
CMS Sends a Message on Stents
Reimbursement for drug-coated stents (DRG 246, 247) equals out to less than a 2% increase for 2010. In comparison, bare metal stents rose over 4% (DRG 249, 250). Considering the unadjusted consumer price index for hospitals and related service rose 7.5% in the last 12 months, maybe CMS is trying to tell us something. Read More »
Making Ends Meet
While doing some research, I came across some information on knee and hip replacement and found that Medicare payment levels increased between 3 and 5% from 2009 to 2011. This doesnt seem like much considering I typically recommend that hospitals negotiate implant increases at no more than 3% per year, but with implants making up to 50% of the procedural costs, margin must be getting pretty tight. Read More »
Remote Monitoring: Simple and Effective
Fascinating remote monitoring technology may be a simple solution to help reduce hospital readmissions. It is estimated that unplanned hospital readmissions cost Americans over $17 billion a year and, therefore, has become a focus for cost reduction in upcoming legislation. Even in its basic form, the technology has the ability to transmit a patients vital signs to a central location either by phone or over the internet. Telemedicine is not revolutionary; it is simply good medicine to follow-up on a patient once they leave the hospital. Read More »
Value-Based Purchasing Comes to Healthcare
Although value and quality may be an old cliché that always turns up in car ads, for a patient paying the bill, shouldnt they have the same mindset for a new knee or hip that costs as much as a car? Starting Oct. 1, 2012, CMS will institute the national hospital value-based purchasing (VBP) program as mandated by the Patient Protection and Affordable Care Act (PPACA). Its amazing how some hospitals really get the connection that technology can have a large impact on value and patients outcomes. Read More »