How are comorbidities for RA patients managed outside of rheumatology? A recent Canadian study developed and assessed quality measures related to preventive care and screenings for RA patients in a primary care setting, comparing RA and non-RA patients. The results: Primary care physicians often provide similar levels of care to patients with and without RA. But RA patients were less likely to receive some cancer screenings and all necessary tests to assess their cardiovascular risk…
Search results for: primary care provider
ACR Opposes UnitedHealthCare’s Move to End Consultation Reimbursement
Effective for claims with dates of service on or after Oct. 1, 2017, UnitedHealthCare (UHC) plans to no longer reimburse consultation services represented by CPT codes 99241–99245 and 99251–99255. In lieu of a consultation services procedure code, UHC says it will “reimburse the appropriate evaluation and management (E/M) procedure code which describes the office visit,…
Bigger, More Expensive Healthcare Practices Not Necessarily Better
(Reuters Health)—You might not get what you pay for when it comes to healthcare, a new study hints. A report in Health Affairs on May 2 found little association between how much physician practices charged and patients’ perceptions of their quality of care.1 “We’re asking consumers to make a lot of decisions about healthcare purchasing…
The ACR Participates in Workgroup to Aid Transition of Pediatric Patients to Adult Healthcare Settings
Recognizing that gaps often occur in the transition process for young adults as they transition from pediatric to adult healthcare, in particular for youth with special healthcare needs, the American College of Physicians’ (ACP’s) Council of Subspecialty Societies (CSS), of which the ACR is a member, initiated a project and engaged several medical specialty organizations…
Medicare Advantage Grows, but Provider Choice Is Limited
CHICAGO (Reuters)—Medicare enrollees are moving in greater numbers than ever to the program’s managed care option as a way to save money. But the tradeoff is much less ability to use their preferred doctors and hospitals. Seniors can choose between traditional fee-for-service Medicare—which is accepted by most healthcare providers—or a Medicare Advantage plan. The latter…
Wise Transitions: Improving Pediatric–Adult Care
Transitions in medical care can be high-risk periods due to the loss of continuity in care and worsening of medical conditions. Approximately one-quarter of the estimated 18 million adolescents aged 18–21 years in the U.S. have chronic conditions, including rheumatic diseases. Interventions in rheumatology practice can improve transition processes. Transition-readiness assessment tools and transition-satisfaction scales are available for use in rheumatology transition processes…
Opinion: Why Rheumatologists Should Adhere to Standard of Care
It is valuable to understand the semantics of consultant comments. A journal article I once read indicated that when a consultant reports having seen a series of individuals with a given problem, it means they have seen two cases. When they report they have experience with a problem, they mean they have seen a (one)…
How Medicare’s Chronic Care Management Payments Could Affect Primary Care
(Reuters Health)—Medicare’s new “chronic care management” (CCM) payment program could make it more financially feasible for physicians to deliver services between visits. Under the new program, Medicare could reimburse primary care practices about $40 month for such things as medication management and communication with other doctors for patients who have two or more chronic medical…
Chronic Care Management Payments Can Increase Primary Care Revenues
NEW YORK (Reuters Health)—Medicare’s new chronic care management (CCM) payments could boost revenues for primary care practices, but many could experience net losses due to opportunity costs of face-to-face visit time, according to results from a modeling study. “The loss of revenue when MD’s did all the work themselves was somewhat surprising,” Dr. Sanjay Basu,…
New Recommendations Support Effective Use of Telemedicine in Primary Care
NEW YORK (Reuters Health)—The American College of Physicians (ACP) has issued a baker’s dozen of recommendations intended to guide the effective use of telemedicine in primary care settings. “The recommendations balance the potential benefits and expanded use of telemedicine with the importance of maintaining the patient-physician relationship and patient safety,” Hilary Daniel from American College…
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