How Radiology Maintains Relative Value Units But Could Lose Big in Reimbursement: The Power of the Conversion  Factor

Within health care reform, it is widely accepted that primary care practice transformation and delivery are essential  to achieving the nation’s quadruple aim—improving patient and provider experience and the health of the population while decreasing cost. Although accountable care organizations and alternative payment models have been lauded as the summit of this proverbial value escalator [1], much of our cu rrent health care system can be found at lower levels on the ascent [2]. For those who are not there yet, how does CMS adjust how primary care services are paid in a fee-for-service environment to incentivize preventive care? And, lest our readers worry they have picked up the wrong journal, how do these reimbursement adjustments affect radiologists and the patients for whom we provide care? The answer begins with a tour of the reimbursement process using office visit codes as an example and ends with a recent Medicare policy that will result in a significant impact on payment for radiology s ervices beginning in 2021.
Source: Journal of the American College of Radiology : JACR - Category: Radiology Authors: Tags: Opinion Source Type: research

Related Links:

Source: RWJF - Upcoming Calls For Proposals - Category: Health Management Authors: Source Type: news
We report a rare case of 74-year-old female of primary hyperparathyroidism caused by parathyroid carcinoma (PC) and coexisting multiple parathyroid adenomas. She was referred to our hospital for primary hyperparathyroidism and a suspected thyroid tumor. She had no family history of malignant tumor. Computed tomography (CT) and ultrasonography of the neck revealed some masses posterior to both thyroid lobes. Those masses were believed to be parathyroid lesions. However, another mass located posterior to the right upper thyroid lobe seemed to be heterogeneous, which indicated a malignant thyroid tumor as well as parathyroid ...
Source: Endocrine Journal - Category: Endocrinology Tags: Endocr J Source Type: research
We describe a unique, complex case of a man resulted affected by both APS-2 and MEN-2a. The patient developed Hashimoto's thyroiditis, diabetes mellitus type 1 and AAD, despite testing negative for adrenal cortex autoantibodies (ACA) and steroid 21-hydroxylase autoantibodies (21-OHAb). Moreover, he had also a family history for MEN-2a and he first developed medullay thyroid cancer, then bilateral pheochromocytoma on the adrenal substrate of an AAD. On adrenal histology we found complete bilateral cortical atrophy in the presence of a lymphocytic infiltration and fibrosis, confirming an ACA and 21-OHAb-negative AAD. This da...
Source: Endocrine Journal - Category: Endocrinology Tags: Endocr J Source Type: research
CONCLUSIONS: The ATA risk stratification system is a reliable predictor of short-term outcomes in patients with DTC in real-world clinical settings characterized by center heterogeneity in terms of size, location, level of care, local management strategies, and resource availability. PMID: 32475305 [PubMed - as supplied by publisher]
Source: Thyroid : official journal of the American Thyroid Association - Category: Endocrinology Tags: Thyroid Source Type: research
In conclusion, we suggest that in the presence of intolerance or resistance to colchicine, interleukin (IL)-1 inhibition could suppress peritoneal inflammation and prevent MSTs. PMID: 32477360 [PubMed - in process]
Source: Pain Physician - Category: Anesthesiology Authors: Tags: Front Immunol Source Type: research
CONCLUSION: Inpatient consultations is very useful to the patient and managing physician. Although a better knowledge in the identification of common ophthalmic conditions can help to reduce the number of inpatient consults from other medical specialties. PMID: 32476114 [PubMed - in process]
Source: Pain Physician - Category: Anesthesiology Authors: Tags: West Afr J Med Source Type: research
CONCLUSIONSAmong women with a high school diploma, elements other than childbearing and marital status —such as contraceptive preferences and access—appeared to influence their contraceptive behavior. Sterilization differentials between high school and college graduates may reflect or exacerbate other socioeconomic disparities that affect women's health and well‐being.
Source: The Guttmacher Institute - Category: International Medicine & Public Health Authors: Source Type: news
England's child protection system is intended to safeguard young people at risk of significant harm - physical, sexual, emotional abuse and neglect. When young people are physically assaulted, stabbed or groomed into drugs trafficking they experience signi...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Age: Adolescents Source Type: news
This article employs a range of sources to critically explore the role of children and young people in county lines drug dealing, the potential harms they are exposed to and the difficulties of protecting them. As county lines centre upon the movement and ...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Age: Adolescents Source Type: news
Limb fractures are the most common injuries in pediatric orthopedics. Early and late complications are often not preventable, even when providing the best treatment; furthermore, these injuries are largely implicated in medico-legal claims. The development...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Age: Adolescents Source Type: news
More News: Environmental Health | Health Management | Medicare | Primary Care | Primary Care Practices | Radiology