by Caroline Fife, M.D. | Jul 15, 2019 | Cassandra Chronicles: Regulatory and Coverage Policy, Fight the Good Fight, Healthcare Payment Policy
Depiction of Total Per Capita Cost (per provider) After CMS calculates Medicare Spending Per Beneficiary (MSPG), it calculates a practitioner’s Total Per Capita Cost. This is the overall cost of care provided to each of the beneficiaries attributed to a specific...
by Caroline Fife, M.D. | Jul 11, 2019 | Cassandra Chronicles: Regulatory and Coverage Policy, Fight the Good Fight, Healthcare Payment Policy
I need to start with a disclaimer that I have no expertise when it comes to Medicare cost calculations. I am muddling through this by reading the materials on the CMS website. If you have a correction to anything I’ve posted or have better insight, I really want to...
by Caroline Fife, M.D. | Jul 10, 2019 | Cassandra Chronicles: Regulatory and Coverage Policy, Fight the Good Fight, Healthcare Payment Policy
A few people are starting to whisper about their experience with the Targeted Probe and Educate (TPE) process directed at claims for Hyperbaric Oxygen Therapy (HBOT). The Medicare Administrative Carriers (MACs) are supposed to educate the doctor, but so far, the...
by Caroline Fife, M.D. | Jul 8, 2019 | Fight the Good Fight
To paraphrase Bum Phillips, “There’s two kinds of doctors, them that’s been sued and them that’s gonna be sued.” I’ve been sued more than once but they were all “non-suited” except one. When I was on the medical school faculty, the University paid a settlement on my...
by Caroline Fife, M.D. | Jul 3, 2019 | Healthcare Payment Policy
There are days I feel like I am the only person who did not get the office memo. That’s how I feel about Disposable Negative Pressure Wound Therapy (dNPWT) when the patient has a home health agency. dNPWT has made NPWT more practical and convenient for smaller...
by Caroline Fife, M.D. | Jul 1, 2019 | Fight the Good Fight, Healthcare Payment Policy
Guest Post Written by Jule Crider As has been reported widely in the press, the President issued an Executive Order (EO) last week on price transparency that has implications for all healthcare providers. I have pasted below excerpts from the American Hospital...
by Caroline Fife, M.D. | Jun 27, 2019 | Fight the Good Fight, Healthcare Payment Policy
“The wounds with no name” (WWNN) are wounds that are due to trauma (not surgical complications) that never heal, PLUS the chronic ulcers that are NOT diabetic, arterial, venous or pressure related. These two groups (accidental wounds and ulcers which are not obviously...
by Caroline Fife, M.D. | Jun 24, 2019 | Don't Miss This
If you have been in wound care awhile, you know that a lot of it is pattern recognition. It’s a game of “duck, duck, goose.” I am not sure I would have figured these two cases out, except that I happened to be seeing both patients during the same time frame. That by...
by Caroline Fife, M.D. | Jun 17, 2019 | Don't Miss This
As any wound care practitioner knows, you can work your way through the Merck Manual of Rare Diseases every year because wounds are a SYMPTOM of disease. If there’s a rare condition, it will probably end up in the wound center. The question is whether we recognize it....
by Caroline Fife, M.D. | Jun 14, 2019 | Don't Miss This
About four years ago I went to Thomazeau, Haiti with the organization Live Beyond. Just before I left, I received an email alert about a significant outbreak of Chikungunya disease. My response was the “Chicken-What?” I had never heard of it, although it affects...
