by Caroline Fife, M.D. | Feb 28, 2019 | Fight the Good Fight, Pressure Cooker: Rethinking Pressure Ulcers
Successful Strategies for Winning Pressure Injury Litigation against Health Care Providers Talk about why they should be able to “Get to Zero!” Use the facility’s “Pressure Ulcer Prevention Protocols” against them. Use the NPUAP Staging System – the Plaintiff’s best...
by Caroline Fife, M.D. | Feb 27, 2019 | Healthcare Payment Policy
Mario from New Life Brace and Limb came to the rescue again. He’s working on a device to off-load the spine of a quadriplegic who is going to put my son through graduate school with his pressure ulcer challenges. Every time we fix one problem, it causes another...
by Caroline Fife, M.D. | Feb 25, 2019 | Healthcare Payment Policy
Remember Hyperbaric Prior Authorization which CMS had in effect for 3 states? They didn’t have to extend the program because it was so successful. Here’s a graph of the impact from 2014 to 2016 in which HBOT utilization decreased by 50%, and not just in those 3...
by Caroline Fife, M.D. | Feb 21, 2019 | Healthcare Payment Policy
I’ve got a lot of patients who have had very targeted local radiation. Some of them got radiation years ago for really questionable reasons, the others for only recently. The non-healing wounds present in the irradiated field can be small but really persistent. The...
by Caroline Fife, M.D. | Feb 19, 2019 | Healthcare Payment Policy
This message was left on the voice mail of our Wound Clinic Program Director. I’ve cut out any patient identifiers and the name of the payer. She’s providing a list of the documentation needed for her to authorize hyperbaric oxygen therapy: [regarding patient...
by Caroline Fife, M.D. | Feb 18, 2019 | Healthcare Payment Policy, Quality Payment Program
We have a serious problem with mistaken identity as wound care practitioners, and I don’t know what we are doing to do about it. I’ve told you that Medicare is holding me accountable for all the wound center patients with CHF and diabetes that get re-hospitalized each...
by Caroline Fife, M.D. | Feb 15, 2019 | Healthcare Payment Policy
I don’t want to sound like a doomsday lunatic, since there are enough of those running for President. Besides, I’m not qualified to run for President since I can do simple MATH. I’ve pointed out that in 2016, I looked at my “Quality and Resource Use Report” (QRUR) and...
by Caroline Fife, M.D. | Feb 14, 2019 | Miscellaneous Musings
Happy Valentine’s Day to my Wonderful Nurses – I appreciate your clinical expertise, your hard work, your teamwork and your cheerfulness! Caroline Fife, M.D.Dr. Fife is a world renowned wound care physician dedicated to improving patient outcomes...
by Caroline Fife, M.D. | Feb 12, 2019 | Healthcare Payment Policy
There’s a contradiction in the field of wound care that we have got to come to terms with. The annual cost of caring for the 15% of Medicare beneficiaries with chronic wounds is at least $28 Billion per year, but it might be as high as $96 Billion per year, and most...
by Caroline Fife, M.D. | Feb 11, 2019 | Don't Miss This, Pressure Cooker: Rethinking Pressure Ulcers
I recently saw a patient with digital ischemia who got improvement in both pain and tissue viability with transdermal oxygen from the OxyBand dressing. There are a lot of possible reasons for digital ischemia, so it’s important to know why the patient has ischemic...