ACR members are spread out across the U.S., but we all work in the same place: the land of fee for service. FFS, as it’s known to policy nerds, poses certain problems for cognitive subspecialists like rheumatologists. For instance, much of the work we do—calling providers and patients, coordinating care after hours—often isn’t compensated. And…
Insurance Subcommittee Responds to Health Plan Complaints
The ACR Insurance Subcommittee (ISC) regularly engages with insurance companies to discuss concerns raised by ACR members and advocate for appropriate coverage and payment policies. The ISC has gotten off to a busy start in 2017, working on a variety of patient access and reimbursement issues. Two recent issues the ISC has taken action on…
New Position Paper Aims to Reduce Administrative Tasks in Healthcare
NEW YORK (Reuters Health)—A new position paper from the American College of Physicians (ACP) aims to reduce administrative tasks in health care. Reducing these tasks has been an important long-term objective of ACP, which developed the Patients before Paperwork initiative in 2015 as part of this effort. In a publication online on March 27 in…
U.S. House Vote Looms; Trump Struggles to Win Obamacare Repeal
WASHINGTON (Reuters)—U.S. President Donald Trump made a final push on Thursday to win over skeptical members of his own Republican Party to begin dismantling Obamacare in the House of Representatives or risk failure on one of his top legislative priorities. The effort is seen by financial markets as a crucial test of Trump’s ability to…
Uncertain Fate of Obamacare Causes Some Hospitals to Halt Projects, Hiring
WASHINGTON (Reuters)—Uncertainty surrounding the Republican plan to replace Obamacare is forcing some U.S. hospitals to delay expansion plans, cut costs, or take on added risk to borrow money for capital investment projects, dealing an economic blow to these facilities and the towns they call home. Hospitals typically lay out multi-year operating plans that prioritize investments,…
Hospitals Have Lower Death Rates During Surprise Inspections
(Reuters Health)—Patients may be less likely to die in U.S. hospitals during weeks when accreditation inspectors show up unannounced than during other times of the year, a recent U.S. study suggests. Researchers examined mortality data for 1,984 hospitals nationwide from 2008 to 2012. During surprise inspections, 7.03% of patients died within 30 days of being…
Rheumatology March Coding Corner Answer: Pediatric Rheumatology Consult
Take the challenge. CPT: 99203 This encounter is coded as 99203, because it included: History—The history of present illness was extended. The review of systems was complete, and the past medical, family and social were documented. This makes the history comprehensive. Examination—Expanded detailed. Medical decision making—The diagnosis was a new problem with no additional workup…
Rheumatology March Coding Corner Question: Pediatric Rheumatology Consult
A 13-year-old black male, described by his mother as a very active and energetic child, is referred to a pediatric rheumatologist. His chief complaint is muscle pain in both legs, which he has experienced for the past three weeks. His mother is a patient of an adult rheumatologist at this clinic and is quite concerned….
Quality Measures Used to Assess Care, Improve Outcomes in Children, Adults with Rheumatic Diseases
WASHINGTON, D.C.—In a session during the 2016 ACR/ARHP Annual Meeting, aptly called Quality Measures and Quality of Care I, a panel of experts presented information on a number of programs underway in rheumatology using quality measures to both assess and improve patient outcomes. Leading off were two presentations on programs using quality measures to improve…
Credit Card Program Helps Physician Practice Manage Its Income
As Erin L. Arnold, MD, partner, Orthopaedics and Rheumatology of the North Shore, in Skokie, Ill, observed patients’ health insurance deductibles and copays getting dramatically higher and higher, she decided that it was time to explore a program that would require patients to keep a credit card on file. “As a private practice and small…
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