Great news! Representatives Larry Bucshon (R-Ind.) and Ami Bera (D-Calif.), are introducing a bill that would prevent a 4.4 percent Medicare physician fee payment cut from taking effect on January 1, 2023, through the introduction of the Medicare Access and CHIP Reauthorization Act of 2015 and associated payment mechanism.
This is the bill we have been requesting from members of the Congress to introduce for some time for the last few months. ASIPP has supported this and ASIPP members have sent over 5,000 letters to Members of the Congress to date.
Representatives Bucshon and Bera are supported in this endeavor by six additional representatives, Kim Schrier M.D. (WA-08), Michael Burgess, M.D. (TX-26), Earl Blumenauer (OR-03), Brad Wenstrup, D.P.M. (OH-02), Bradley Schneider (IL-10), and Mariannette Miller-Meeks, M.D. (IA-02). Together they sent a Request for Information: Medicare Payment System Reform letter to members of Congress. See RFI Letter
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The hospital and health system landscape in 2022 is dominated by warnings of major financial losses, often attributed in part to the rising costs of labor.
A nursing shortage and the winter’s omicron surge forced many provider organizations to turn to contract workers demanding rates far beyond those seen prior to the pandemic.
Systems say those prices are stabilizing with each passing month. However, many hospitals’ depleted budgets are now having to contend with economywide wage and supply cost increases at a time when high-profit volumes (such as surgeries) are still recovering from pandemic disruptions.
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Register today for the CALSIPP Annual Meeting and join us for an Evening Cruise on the Bay!
Saturday, October 15 | 7:30 pm
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Enjoy an entertaining three-hour yacht cruise around Newport Bay on a two-level contemporary yacht. Take in the beautiful sights from the outdoor viewing areas on the large bow, aft deck, or by strolling the walk-around decks.
Limited tickets are available, so do not wait! Tickets are $100 per registered meeting attendee or guest and must be selected on the registration form.
Register for the meeting and select the Cruise Add On.
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The Last Day to Reserve Your Room at a Highly Discounted Rate is Thursday, September 29! |
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Hospitals across the country have seen their per-patient labor expense increase by more than a third since 2019, largely due to the spike in contract labor prices during the delta and omicron surges, Kaufman Hall reports.
Between 2019 and March 2022, the median labor expense per adjusted discharge rose 37% from $4,009 to $5,494, the firm wrote in a new report, citing monthly data from over 900 hospitals polled by Syntellis Performance Solutions.
“The pandemic made longstanding labor challenges in the healthcare sector much worse, making it far more expensive to care for hospitalized patients over the past two years,” Erik Swanson, senior vice president of data and analytics at Kaufman Hall, said in a statement. “Skyrocketing labor costs, decreasing patient volume and lower revenues create a perfect storm for steep declines in profit margins. Hospitals now face a number of pressures to attract and retain affordable clinical staff, maintain patient safety, deliver quality services and increase their efficiency.”
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NEXT EXAM DATES:
Part I
October 22, November 19, & December 17
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"The pandemic is over," he said. "We still have a problem with COVID. We're still doing a lot of work on it. But the pandemic is over. If you notice, no one's wearing masks. Everybody seems to be in pretty good shape, and so I think it's changing, and I think [the Detroit auto show resuming after three years] is a perfect example of it."
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Pfizer’s Breakthrough Fellowship Program, which provides rising Black, Latino and Native American college seniors with summer internships, two years of employment post-college and a scholarship, has attracted some detractors.
In a new lawsuit, the organization Do No Harm says the program is discriminatory. The group, which is comprised of medical and healthcare professionals who aim to “protect healthcare from a racist, divisive, and discriminatory ideology,” argues the program “categorically excludes” white and Asian-American applicants and is therefore illegal.
The case hinges on the fact that Pfizer receives federal financial assistance by accepting reimbursement from federal healthcare programs such as Medicare and Medicaid. That means all of the company’s operations are covered by federal prohibitions on racial discrimination, Do No Harm says.
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Please plan to join us at the
2023 ASIPP Annual Meeting
March 16-18 National Harbor, Maryland
Register Early
More details will be posted on our website at asipp.org.
Registration begins November 2022.
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For meeting or exhibitor/sponsor information:
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Officials also plan to keep buprenorphine prescribing flexibilities for 1 year after the PHE ends
The Biden administration announced several new actions aimed at tackling the opioid overdose crisis, including more funding for states and territories and new guidance designed to increase access to naloxone (Narcan).
"Our nation is facing 108,000 overdose deaths in just 12 months," said Rahul Gupta, MD, director of the White House Office of National Drug Control Policy (ONDCP), on a phone call with reporters Thursday evening. "That's one life lost every 5 minutes around the clock ... Our North Star is to save lives and connect more Americans to treatment and recovery support services. We have already seen our efforts take effect. After a more than 35% increase in overdose deaths during the first 18 months of the pandemic, more recent 12-month rolling total overdose death counts have remained largely unchanged."
Actions announced by the administration on Friday include:
- $1.5 billion in funding to states and territories to address addiction and the opioid crisis.
- $104 million in funds to expand substance use treatment and prevention in rural areas.
- New guidance to increase access to naloxone.
- More funding for law enforcement.
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- ASIPP Members Only Site Information - |
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To log in for the first time you will need to click “forgot password” at the bottom of the login window.
- Check your email and then log in as directed.
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If you have problems logging into your account, click here.
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Technology can nudge everyone from support staff to surgeons to make decisions that ultimately boost outcomes and enhance the bottom line, one AI health IT expert explains.
Behavioral science is used to get people to perform certain behaviors, including ones they may not typically embrace.
Clinicians, especially surgeons, generally do not like to be told what to do, and certainly not by technology like artificial intelligence.
Mudit Garg, CEO of Qventus, a vendor of AI-powered health IT, and a former McKinsey & Co. healthcare consultant, here shares insights with Healthcare IT News about how behavioral science can be combined with AI and machine learning technology to increase utilization and improve physician satisfaction.
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Pain Medicine Case Reports (PMCR) and Editor-in-Chief Alaa Abd-Elsayed, MD, PhD would like to invite you to submit case reports and case series to the PMCR journal. Your article will be published free of charge.
Open access journals are freely available online for immediate worldwide open access to the full text of published articles. There is no subscription fee for open access journals. Open access journals are no different from traditional subscription-based journals: they undergo the same peer-review and quality control as any other scholarly journal.
Interested in becoming a member of the PMCR Editorial Board?
Editorial board members are asked to review 2-6 manuscripts per year. Please submit your most up-to-date CV to sgold@asipp.org for consideration.
For more information or to submit your articles, click here.
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| CASE REPORT |
Benedict Moran, BS, Anna Grosse, RN, Rebecca Speltz Paiz, MD, PhD, Angela M. McArthur, MPH, Drew Rosielle, MD, and Vasudha Goel, MBBS
Abstract
BACKGROUND: Intrathecal drug delivery systems (IDDS) may pose additional restrictions on terminal cancer patients in their end-of-life planning. The patient provided HIPAA-compliant consent for the inclusion of their clinical information in this report.
CASE REPORT: A 62-year-old male with recurrent metastatic spindle cell carcinoma to the ribs and thoracolumbar junction with vertebral compression fracture had an IDDS implanted to manage cancer-related pain. The patient had approached a funeral home to plan his last rites with a preference for cremation. However, the funeral home advised the patient that special precautions were not required for cremation with an IDDS.
CONCLUSION: The medical device disposal process can be improved through formal communication between the medical team members and the funeral home directors. Device disposal education can ensure safe disposal and prevent cremation-related adverse events.
KEY WORDS: Intrathecal drug delivery systems, palliative care, end of life, cremation
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| SYSTEMATIC REVIEW |
Van Bogaert Wouter, MSc, Tegner Heidi, MSc, Coppieters Iris, PhD, Huysmans Eva, PhD, Nijs Jo, PhD, Moens Maarten, MD, PhD, Goudman Lisa, PhD, Buyl Ronald, PhD, and Lundberg Mari, PhD
Abstract
BACKGROUND: Currently, evidence regarding fear avoidance beliefs as potential predictors for lumbar surgery outcomes seems insufficient and strong conclusions are not yet available.
OBJECTIVE: This systematic review aimed to evaluate the predictive value of preoperative fear avoidance beliefs for postoperative pain intensity, functional status, and health-related quality of life following surgery for lumbar degenerative disease.
STUDY DESIGN: Systematic review and best evidence synthesis.
METHODS: An extensive search was performed in PubMed/Medline, EMBASE, PsycINFO, CINAHL and the Cochrane library for articles published up until October 2021. Two independent reviewers performed the screening, data extraction, and quality assessment, with a third independent reviewer consulting to resolve any disagreement. Observational studies that included patients undergoing surgery for lumbar degenerative disease, as well as evaluated fear avoidance beliefs (i.e., pain-related fear, pain catastrophizing, pain anxiety) in relation to a surgical outcome measure (i.e., pain intensity, functional status and health-related quality of life) were included in the review. The CHARMS- and QUIPS-tools were used for data extraction and quality assessment, respectively. A best evidence synthesis was performed resulting in conclusions regarding strong, moderate, conflicting, and limited levels of evidence.
RESULTS: A total of 24 studies (n = 17,881) were included in this review. Following best evidence synthesis, 3 included studies reported no significant predictive value of preoperative pain-related fear for postoperative pain intensity resulting in moderate evidence for this relationship. Moderate evidence was also found indicating no significant predictive value of preoperative pain-related fear for postoperative functional status, as 6 out of 8 relevant studies reported this result. Only one study reported on the predictive value of preoperative pain catastrophizing for postoperative health-related quality of life, resulting in limited evidence for the absence of this predictive relationship. All other relationships were found to have conflicting evidence.
LIMITATIONS: To evaluate surgical outcome, only patient-reported outcome measures as used by spine registries were included. Thus, our findings cannot be extrapolated to all surgery outcomes following lumbar degenerative disease and should only be interpreted in relation to postoperative pain intensity, functional status, or health-related quality of life.
CONCLUSION: Best evidence synthesis showed moderate evidence indicating that preoperative pain-related fear is not a significant predictor for postoperative pain and function following surgery for lumbar degenerative disease. Additionally, limited evidence was found for a lack of predictive value of preoperative pain catastrophizing for postoperative health-related quality of life. As current evidence regarding the predictive value of preoperative fear avoidance beliefs following such a surgery is mixed, further research is required before more definitive conclusions can be made.
KEY WORDS: Lumbar surgery, pain catastrophizing, pain-related fear, anxiety, fear avoidance, lumbar degenerative disease, pain intensity, function, quality of life
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| SYSTEMATIC REVIEW |
Michael Appeadu, MD, Natalia Miranda-Cantellops, MD, Brittany Mays, MD, Marisa Mason-Carino, BS, John Reynolds, MLIS, Thilani Samarakoon, PhD, Teshamae Monteith, MD, and Chane Price, MD
Abstract
BACKGROUND: Cervicogenic headache (CGH) can often be difficult to treat, given the overlapping clinical features of other headaches and the varying sources of pain that patients report. While imaging is not useful in diagnosing CGH, anesthetic blockade of the atlanto-occipital joint, lateral atlantoaxial joint, or specific cervical zygapophyseal joints can be used to confirm the diagnosis. When conservative treatment measures, such as physical therapy, fail, interventional techniques, such as intraarticular steroid injections, have been shown in observational studies to provide relief in some patients.
OBJECTIVES: To determine the efficacy of intraarticular cervical facet steroid injections in the treatment of CGH.
STUDY DESIGN: Systematic review and meta-analysis.
METHODS: We conducted a comprehensive search of Ovid Medline, Embase, Cochrane Central Register of Controlled Trials , Cumulative Index to Nursing and Allied Health Literature Plus with Full Text, Scopus, and the Web of Science platform, from inception to April 2021, for studies using intraarticular cervical facet injections to treat CGH in adults aged 18 or older. Primary outcomes included mean postinjection pain scores. Outcomes were pooled using a random effects model and reported as mean differences (MD) with 95% confidence intervals (CI).
RESULTS: Three studies with a total of 64 patients met the inclusion criteria. According to data from each of the included studies, intraarticular cervical facet injections were shown to demonstrate improvement in the mean pain score from baseline to postintervention. The overall effect size—pooled MD in the Visual Analog Scale score—was 3.299 (95% CI: 2.045 to 4.552, P < 0.001). Heterogeneity (I2) was 36.11%.
LIMITATIONS: Small sample size, lack of control group, and varying pain generators and interventional technique between studies contribute to the limitations of the analysis.
CONCLUSIONS: Our findings suggest that therapeutic intraarticular cervical facet injections may be effective in the treatment of CGH. Because of the heterogeneity among the studies, these results should be interpreted with caution.
KEY WORDS: Cervicogenic headache, cervical facet pain, atlantoaxial joint, atlanto-occipital joint, steroid injection, corticosteroid injection, glucocorticoid injection, intraarticular facet injection, zygapophyseal joint, headache
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Since this malpractice insurance program officially launched in November 2018, ASIPP has signed up hundreds of providers with an average savings of 30%. This is professional liability insurance tailored to our specialty and will stand up for us and defend our practices.
Norcal Mutual is A-Rated by AM best and is licensed in all 50 states. To read a few important points to keep in mind about the program, including discounts, administrative defense, cyber coverage, aggressive claims handling, and complimentary award-winning risk management CME activities, click here.
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ASIPP® has formed a partnership with Henry Schein and PedsPal, a national GPO that has a successful history of negotiating better prices on medical supplies and creating value-added services for independent physicians. Working with MedAssets, PedsPal provides excellent pricing on products like contrast media that alleviate some of the financial pressures you experience today.
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ASIPP® is now offering our members the benefit of a unique revenue cycle management/ billing service.
We have received a tremendous amount of interest in the ASIPP® billing and coding program.
Click here to learn more about the negotiated rate for practices and more!
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up-to-date news related to you, your practice, and your patients!
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