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Pulmonary Rehabilitation Reimbursement Challenges
Respir Care. 2024 Apr 30:respcare.11699. doi: 10.4187/respcare.11699. Online ahead of print.ABSTRACTPulmonary rehabilitation (PR) is a highly effective intervention for persons with chronic respiratory diseases, resulting in improvement in exercise capacity, dyspnea, health-related quality of life, mood, reduced hospitalization, and improved survival and cost savings post-COPD hospitalization. Despite demonstrated effectiveness, PR is underutilized in part due to lack of awareness, limited access, and inadequate PR reimbursement. Poor payment is a long-standing barrier to PR's financial stability and access. Addressing PR ...
Source: Respiratory Care - April 30, 2024 Category: Respiratory Medicine Authors: Chris Garvey Source Type: research

Pulmonary Rehabilitation Reimbursement Challenges
Respir Care. 2024 Apr 30:respcare.11699. doi: 10.4187/respcare.11699. Online ahead of print.ABSTRACTPulmonary rehabilitation (PR) is a highly effective intervention for persons with chronic respiratory diseases, resulting in improvement in exercise capacity, dyspnea, health-related quality of life, mood, reduced hospitalization, and improved survival and cost savings post-COPD hospitalization. Despite demonstrated effectiveness, PR is underutilized in part due to lack of awareness, limited access, and inadequate PR reimbursement. Poor payment is a long-standing barrier to PR's financial stability and access. Addressing PR ...
Source: Rural Remote Health - April 30, 2024 Category: Rural Health Authors: Chris Garvey Source Type: research

Infection Control Advocate and Resident Education (ICARE)
In 2016, the Centers for Medicare and Medicaid Services (CMS) made major revisions to the regulatory requirements to improve the safety and quality of care that would be implemented in three phases (2016-2019). This included major additions to the infection prevention and control (IPC) requirements for nursing homes (NHs), including the requirement of an enhanced IPC plan, an infection preventionist (IP), and the inclusion of the IP in the quality assessment and assurance committee. While NHs were expected to have these requirements in place by the end of 2019, the COVID-19 pandemic overwhelmed NHs and the healthcare syste...
Source: Journal of the American Medical Directors Association - April 30, 2024 Category: Health Management Authors: Sarah E. Ross, Jennifer J. Severance, Sara Murphy, Diana Cervantes Source Type: research

Socioeconomic Disparities in Online Patient Portal Utilization Among Total Knee Arthroplasty Recipients
Since 2021, the Centers for Medicare and Medicaid Services have mandated that patients have open access to their medical records. Many institutions use online portals, which allow patients to access their health information and communicate with care teams. Our research aimed to evaluate demographic patterns for online patient portal utilization in patients undergoing total knee arthroplasty (TKA). Further, we assessed if and how portal engagement contributes to perioperative outcomes. (Source: The Journal of Arthroplasty)
Source: The Journal of Arthroplasty - April 24, 2024 Category: Orthopaedics Authors: Neel Vallurupalli, Kyle W. Lawrence, Akram A. Habibi, Joseph A. Bosco, Claudette M. Lajam Tags: 2023 AAHKS Proceedings Source Type: research

Social Determinants of Long-Term Opioid Use Following Total Knee Arthroplasty
This study utilized data from the Veterans Affairs Surgical Quality Improvement Program, VA Corporate Data Warehouse, and Centers for Medicare and Medicaid Services, including Veterans aged ≥ 65 who underwent elective TKA between 2013 and 2019 with no postsurgical complications or history of significant opioid use. LTO was defined as > 90 days of opioid use beginning within 90 days postsurgery. SDoH variables included the Area Deprivation Index, rurality, and housing instability in the last 12 months identified via medical record screener or International Classification of Diseases, Tenth Revision codes. Multivari...
Source: Journal of Knee Surgery - April 10, 2024 Category: Orthopaedics Authors: Hadlandsmyth, Katherine Lund, Brian C. Gao, Yubo Strayer, Andrea L. Davila, Heather Hausmann, Leslie R. M. Schmidt, Susanne Shireman, Paula K. Jacobs, Michael A. Mader, Michael J. Tessler, Robert A. Duncan, Carly A. Hall, Daniel E. Sarrazin, Mary Vaughan Tags: Original Article Source Type: research

Reimbursement for a Broader Array of Services in Coordinated Specialty Care for Early Psychosis
Psychiatr Serv. 2024 Mar 27:appips20230551. doi: 10.1176/appi.ps.20230551. Online ahead of print.ABSTRACTDespite the growing evidence supporting the benefits of coordinated specialty care (CSC) for early psychosis, access to this multimodal, evidence-based program in the United States has been hindered by a lack of funding for core CSC services and activities. The recent approval of team-based reimbursement codes by the Centers for Medicare and Medicaid Services has the potential to fund substantially more CSC services for clients with insurance coverage that accepts the new team-based billing codes. This streamlined and m...
Source: Psychiatric Services - March 27, 2024 Category: Psychiatry Authors: Matthew E Hirschtritt Brandon Staglin Stuart Buttlaire Kerry Ahearn Sarada Oglesby Lisa B Dixon David Shern Toby Ewing Tara A Niendam Source Type: research

Old tech but not low tech: telephone-based treatment provision for substance use
The future of telemedicine for substance use treatment hangs by a thread, as the United States awaits approval of proposed regulations and laws to increase care access in light of the 2022 Centers for Medicare and Medicaid Services revisions allowing for audio-only care. Telemedicine improves patient care access and outcomes. Audio-only telemedicine can be an effective and viable modality for individuals without technology resources (devices, internet services, and literacy), those with reduced telehealth service utilization (Black individuals or those with unstable housing, who are older, with low income, or with low educ...
Source: Frontiers in Psychiatry - March 19, 2024 Category: Psychiatry Source Type: research

Veterans With PTSD May Benefit From Transcranial Direct Current Stimulation Plus Virtual Reality
Transcranial direct current stimulation (tDCS) may augment virtual reality –guided exposure therapy for veterans with posttraumatic stress disorder (PTSD), according tofindings published yesterday inJAMA Psychiatry. In the study, veterans with war zone –related trauma had significantly greater improvements in PTSD symptoms when receiving virtual reality combined with tDCS compared with veterans who received virtual reality and sham stimulation.Mascha van ’t Wout-Frank, Ph.D., of the VA Providence (R.I.) Healthcare System and colleagues recruited 54 participants (94% male; mean age 46 years) from the system who had PT...
Source: Psychiatr News - March 7, 2024 Category: Psychiatry Tags: exposure therapy post-traumatic stress disorder PTSD Transcranial Direct Current Stimulation veterans virtual reality VR war zone Source Type: research

Factors associated with Ninety-day Reintervention following Lower Extremity Revascularization
Peripheral artery disease (PAD) represents a high volume, high-cost burden on the healthcare system. The Centers for Medicare and Medicaid Services (CMS) has developed the Bundled Payments for Care Improvement-Advanced program, in which a single payment is provided for all services administered in a postsurgical 90-day episode of care. Factors associated with 30- and 90-day reinterventions after PAD interventions would represent useful data for both payors and stake holders. (Source: Journal of Vascular Surgery)
Source: Journal of Vascular Surgery - March 7, 2024 Category: Surgery Authors: Olamide Alabi, Jessica L. Harding, Nader Massarweh, Xinyan Zheng, Luke Brewster, Jialin Mao, Yazan Duwayri Source Type: research

Implications of the Centers for Medicare and Medicaid Services (CMS) Decision to Expand Indications for Carotid Artery Stenting
On October 11, 2023, the United States Centers for Medicare and Medicaid Services (CMS) released a recommendation stating that percutaneous transluminal angioplasty of the carotid artery concurrent with stenting is reasonable and necessary with the placement of a Food and Drug Administration (FDA)-approved carotid stent with an FDA-approved or cleared embolic protection device, for patients with ≥50% symptomatic (SxCS) or ≥70% asymptomatic (AsxCS) carotid artery stenosis.1 For both SxCS and AsxCS patients, CMS advised that prior to furnishing carotid artery stenting (CAS), the practitioner must engage in a formal share...
Source: Journal of Vascular Surgery - March 7, 2024 Category: Surgery Authors: Kosmas I. Paraskevas, Clark J. Zeebregts, Ali F. AbuRahma, Bruce A. Perler Source Type: research