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Wound Care Practitioners Should Screen Patients for Sleep Apnea- Here’s How!

Wound Care Practitioners Should Screen Patients for Sleep Apnea- Here’s How!

by Caroline Fife, M.D. | Aug 19, 2025 | Fight the Good Fight

“You can’t fall asleep while I am talking to you unless we are married.” That’s what I say to all the patients who fall asleep in the exam room. It seemed humorous at first, until I realized that sleep apnea could be the reason that some patients were not healing....
Administration Seeks to Tear Down Digital Walls and Create a Digital Health Ecosystem: “This is a Movement – Not a Mandate”

Administration Seeks to Tear Down Digital Walls and Create a Digital Health Ecosystem: “This is a Movement – Not a Mandate”

by Caroline Fife, M.D. | Aug 14, 2025 | Fight the Good Fight, Healthcare Payment Policy

White House, Tech Leaders Commit to Create Patient-Centric Healthcare Ecosystem | CMS Health Technology Ecosystem | CMS “For decades, bureaucrats and entrenched interests buried health data and blocked patients from taking control of their health,” said HHS Secretary...
Whoopsie! Corrections From Donna Cartwright!

Whoopsie! Corrections From Donna Cartwright!

by Caroline Fife, M.D. | Jul 30, 2025 | Fight the Good Fight, Healthcare Payment Policy

I should leave the coverage interpretation to the professionals. I appreciate all of you who tell me when I make a mistake. Donna Cartwright — who is a genuine expert — provided corrections on that UHC policy: “Epifix and Grafix are the only amniotic...
2023 QPP Performance Data are Out: 14.56% of Practitioners Will See a Penalty in Their 2025 Medicare Payments

2023 QPP Performance Data are Out: 14.56% of Practitioners Will See a Penalty in Their 2025 Medicare Payments

by Caroline Fife, M.D. | Jul 9, 2025 | Fight the Good Fight, Healthcare Payment Policy

CMS has released Quality Payment Program (QPP) performance data for 2023. Under the QPP, payment “adjustments” (bonuses and penalties) occur two years after the “performance year,” so that 2023 scores impact a practitioner’s 2025 Medicare payments. It’s important to...
A Ruptured Appendix and a Broken System

A Ruptured Appendix and a Broken System

by Caroline Fife, M.D. | Jun 23, 2025 | Fight the Good Fight, Pressure Cooker: Rethinking Pressure Ulcers

Dear Dr. Fife, I am writing this letter as a general surgeon who is deeply concerned about our healthcare system. As you have pointed out in your blog, physician payments by CMS and private insurers are a fraction of what they were 20 years ago because physician...
Must Wound Clinics & Mobile Practitioners Report Pressure Injuries / Ulcers Occurring in the Home as SREs?

Must Wound Clinics & Mobile Practitioners Report Pressure Injuries / Ulcers Occurring in the Home as SREs?

by Caroline Fife, M.D. | Jun 20, 2025 | Fight the Good Fight, Pressure Cooker: Rethinking Pressure Ulcers

The National Quality Forum (NQF) has issued a request for public comment about their update on Serious Reportable Events (SREs). Every hospital-based outpatient wound center (HOPD) and “mobile” wound care practitioner needs to read this carefully. I hope all of you...
Myth of the Day: “I am Exempt from MIPS Because I am a ‘Mobile’ Practitioner”

Myth of the Day: “I am Exempt from MIPS Because I am a ‘Mobile’ Practitioner”

by Caroline Fife, M.D. | Jun 16, 2025 | Fight the Good Fight

I hear the most interesting things about when Medicare rules apply and about the requirements of the Merit-Based Incentive Payment System (MIPS). For example, two years ago, a doctor whose practice involved the application of CTPs/skin substitutes on patients in the...
Insights Involving Real-World Evidence and Wound Care

Insights Involving Real-World Evidence and Wound Care

by Caroline Fife, M.D. | Jun 13, 2025 | Fight the Good Fight

I had a great time talking to Elizabeth Anderson of SmartTRAK about what the real world analysis of diabetic foot ulcer and venous leg ulcer patients revealed, including the astounding similarity of their underlying medical conditions and medications. The prevalence...
The Age of Wisdom and the Age of Foolishness: A Tale of Two Wounds

The Age of Wisdom and the Age of Foolishness: A Tale of Two Wounds

by Caroline Fife, M.D. | Jun 11, 2025 | Cellular / Tissue-Based Products, CTP / Skin Substitutes, Fight the Good Fight

I got this letter from a Physical Therapist, and I am publishing it anonymously with his permission. –Caroline Dear Dr. Fife, I am a physical therapist (PT) specializing in wound care. A PT acquaintance of mine has partnered with a Nurse Practitioner (PT) in a...
$1.3 Billion in Potential Savings if Medicare Paid HOPDs at the “Non-Facility” Rate

$1.3 Billion in Potential Savings if Medicare Paid HOPDs at the “Non-Facility” Rate

by Caroline Fife, M.D. | Jun 9, 2025 | Fight the Good Fight

HHS-OIG identified $1.3 billion in potential savings if #Medicare reimbursed provider-based facilities at the non-facility rate. Related reports include recommendations for legislative action and areas where congressional oversight may be warranted. See also: Site...
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