by Caroline Fife, M.D. | May 8, 2024 | Fight the Good Fight
If you are attending the SAWC Spring 2024 Conference next week, come listen to Dr. Marissa Carter and I discuss, “Why are all My Chronic Wound Patients so SICK?” The session is Wednesday May 15, from 1:45 PM – 2:45 PM Eastern, in Crystal K. In the session, we...
by Caroline Fife, M.D. | May 7, 2024 | Fight the Good Fight, Healthcare Payment Policy, Hyperbaric Oxygen Therapy
CMS recently announced that the Total Per Capita Cost (TPCC) cost measure is now open for comment. CMS (through its contractor, Acumen) is gathering comments on the TPCC measure to determine updates to the measure’s attribution methodology (“attribution” is the...
by Caroline Fife, M.D. | Apr 29, 2024 | Fight the Good Fight
I worry a lot about the relationship between obesity and chronic wounds. Obesity is linked to diabetes and diabetic neuropathy. It causes a chronic inflammatory state, it often leads to lymphedema, and it is often associated with chronic leg dependency due to chair...
by Caroline Fife, M.D. | Apr 22, 2024 | Fight the Good Fight, Miscellaneous Musings
The AMA has a very useful series called “What doctors wish patients knew about…“ The most recent one is about a condition called “misphonia.” This is a condition in which seemingly innocuous sounds can trigger an intense (and seemingly out of proportion)...
by Caroline Fife, M.D. | Apr 15, 2024 | Fight the Good Fight, Hyperbaric Oxygen Therapy
The Centers for Medicare & Medicaid Services (CMS) recently announced plans to test prior authorization (PA) for 40 services related to blepharoplasty, botulinum toxin injections, rhinoplasty, panniculectomy, and vein ablation performed in Ambulatory Surgical...
by Caroline Fife, M.D. | Apr 12, 2024 | Fight the Good Fight, Hyperbaric Oxygen Therapy
As anyone knows who has treated a patient with late effects of radiation to the bladder, the impact of HBO2 can be dramatic in terms of improving life-altering symptoms like radiation cystitis which causes bleeding and pain with urination. Some patients can bleed so...
by Caroline Fife, M.D. | Apr 11, 2024 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Fight the Good Fight
I am trying to find ways to visually depict our current situation with regard to Cellular and/or Tissue-based products (CTPs). Several things can be true at once: Package pricing in the hospital-based outpatient department (HOPD) limits the cost per PIECE that a...
by Caroline Fife, M.D. | Apr 9, 2024 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Fight the Good Fight, Healthcare Payment Policy
United Healthcare has updated its Skin and Soft Tissue Substitutes policy effective May 1, 2024, which details the coverage and documentation criteria specifically for EpiFix or Grafix® (GrafixPL, GrafixPRIME and GrafixPL PRIME) (Non-Injectable). The policy also...
by Caroline Fife, M.D. | Mar 25, 2024 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Fight the Good Fight
I’ve posted previous blogs detailing what I’ve learned about the impact of establishing the Average Sales Price (ASP) for products, and the perverse impact that an established ASP seems to have. Here’s a visual example of the insanity of pricing and the problem with...
by Caroline Fife, M.D. | Mar 21, 2024 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Fight the Good Fight
Last week I attended the inaugural Cellular, Acellular, and Matrix-like Product (CAMP) Summit. It was a very interesting and well-run meeting. I will digress to mention the acronym “CAMP” which is gaining traction over the more awkward (and possibly obsolete) Cellular...
