The world in which we currently practice is not the same one we knew five to 10 years ago. Insurers second-guess our decisions and create numerous hurdles for us to overcome before our patients can be treated. Government agencies are seeking ways to reduce healthcare expenditures and improve what they perceive as a lack of quality and consistency in healthcare delivery. These groups, as well as Congress and employers (who purchase benefits for their employees), have begun a concerted effort to grade rheumatologists on the basis of what they perceive to be quality and efficiency and then pay us according to those criteria.
Coding Corner Question
February Coding Scenario
Twenty Questions, Part 1
What disease scores can teach you about rheumatology
Payments Cut to the Bone
CMS reduces reimbursement for DXA and vertebral fracture assessment
Zero Stars for Star-based Physician Ranking
Several insurance companies have tried to share quality information with enrollees by developing “star” systems to rank physicians. While star rankings may be a good way to pick a movie or restaurant, the ACR feels this system may be too simple to serve as a tool for identifying quality healthcare. Consumers need quality information, and need to know the true costs of medical services so they can make informed decisions about their healthcare. This idea is reflected in an executive order President Bush signed in August 2006 requiring government agencies to work with the private sector to gather and share data on the quality and cost of healthcare.
Coding Corner Answer
November’s Coding Answer
Coding Corner Question
January Coding Scenario
ACR Activism Resources
Practice advocacy: not just for private practitioners
Who Will Treat Arthritis in 2005?
ACR study documents shortage of rheumatologists and predicts greater shortfalls to come
Medicare D-lemmas
Rheumatologists and patients report mixed experiences with the new prescription drug benefit