by Caroline Fife, M.D. | Oct 4, 2019 | Healthcare Payment Policy
On Thursday, President Trump signed an executive order to equalize payment among sites of service. The order says that HHS should make sure Medicare pay and policies “encourage competition and a diversity of sites for patients to access care,” and directs CMS to look...
by Caroline Fife, M.D. | Sep 30, 2019 | Healthcare Payment Policy, Quality Payment Program, US Wound Registry
Do you still have the photos of the first patient you treated with the VAC? Here are the 1997 photos of my first VAC patient, only 2 years after the device was cleared by the FDA. I know the photo quality is terrible – they were originally Polaroids! My point is that...
by Caroline Fife, M.D. | Sep 19, 2019 | Healthcare Payment Policy
I have been using DNA assay of wounds for a decade, but am still trying to figure out how best to employ this technology. Here’s an example of why it is needed at times: This is a frail lady who is devoted to her dogs. Her wound had been making progress at a glacial...
by Caroline Fife, M.D. | Aug 30, 2019 | Healthcare Payment Policy
If you are like me, the fun part about the Labor Day holiday is that there’s no traffic on Monday when you drive to work… Here’s an interesting bit of fodder for your drive to work on the Labor Day holiday. I follow the blog of Knicole Emanuel, an attorney in...
by Caroline Fife, M.D. | Aug 28, 2019 | Fight the Good Fight, Healthcare Payment Policy
I am just going to say it. The majority of prospective trials in wound healing have enrolled subjects whose wounds were more likely to heal than not. While more “generalizable” trials (meaning, actually relevant to real patients) are underway or in the planning...
by Caroline Fife, M.D. | Aug 15, 2019 | Healthcare Payment Policy, Hyperbaric Oxygen Therapy
Noridian has started sending out letters to notify hospitals of post-payment review of outpatient HBOT charged records from 2018 (G0277). See below for the pitfalls of writing the usual HBOT note. If you do not order the HBOT for that day, you will likely not get...
by Caroline Fife, M.D. | Aug 5, 2019 | Fight the Good Fight, Healthcare Payment Policy
By Helen Gelly, MD Most people these days know their Credit Score. There are “apps” to check it and to improve it, even though it may be calculated in a complex way from a lot of factors. And even though the financial impact of a low credit score may be indirect, most...
by Caroline Fife, M.D. | Jul 24, 2019 | Cassandra Chronicles: Regulatory and Coverage Policy, Fight the Good Fight, Healthcare Payment Policy
I started this series of blogs with a discussion of Medicare audits and the impending bankruptcy of Medicare. We determined that audits come from perceived improper use and the reason that audits are accelerating is the impending bankruptcy of Medicare. Medicare is...
by Caroline Fife, M.D. | Jul 22, 2019 | Cassandra Chronicles: Regulatory and Coverage Policy, Fight the Good Fight, Healthcare Payment Policy
Every practitioner is being positioned on a grid in relation to the cost of care as described, and their quality score which is usually a score obtained from MIPS quality reporting. The ideal position on the grid is the top right corner. To CMS, that person delivers...
by Caroline Fife, M.D. | Jul 18, 2019 | Cassandra Chronicles: Regulatory and Coverage Policy, Fight the Good Fight, Healthcare Payment Policy
Why do my patients cost so much? I showed you the numbers in my MIPS “cost” category which concluded that I spend $58,000 per episode rather than $16,000, which is the average for a family practice doctor. Remember that these costs are being triggered by...