(Reuters)—U.S. President Donald Trump’s expected plan to let Americans buy insurance across state lines could violate federal law governing employee benefit plans and will almost certainly be challenged in court, several legal experts said. Trump said on Tuesday he would likely sign an executive order this week allowing people to cross state lines to obtain…
Search results for: Primary care
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,…
How Global Geographic Disparities Affect Healthcare Outcomes
Your home & your health: Does geography impact medicine? Does it matter whether a region is surrounded by large bodies of water, encircled by towering mountain peaks or that its residents share a common ancestry? Consider Switzerland, a nation with a highly developed economy replete with advanced technological and medical infrastructure. Despite these advantages, less…
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…
Biomedical Research Key to Advancing Clinical Care for Rheumatic Diseases
WASHINGTON, D.C.—The importance of biomedical research to advancing clinical care with the ultimate goal of improving patients’ lives was on display during an ACR Discovery 2016 plenary session at the 2016 ACR/ARHP Annual Meeting. The session offered new ways to think about and treat select rheumatologic diseases, including research showing for the first time the…
2016 ACR Distinguished Fellows Award Winners Discuss Early Career Contributions to Rheumatology
For they’re some very good fellows … no, seriously. They are this year’s recipients of the ACR Distinguished Fellows Awards. The Rheumatologist spoke with them about their burgeoning contributions to Advancing Rheumatology! ACR Distinguished Fellow Awards Eric Allenspach, MD, PhD Acting Assistant Professor, Seattle Children’s Hospital, Seattle Background: Dr. Allenspach seeks to understand the genetic basis…
Gout Treatment & Care Remain Suboptimal
A recent analysis compared the care of patients with RA with that received by patients with gout, finding that hospitalization and costs for patients with gout have increased, but both are decreasing for patients with RA. Unlike RA, significant advances in treatment have not been made for gout, despite its increasing prevalence, and patients may land in the hospital unnecessarily…
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…
Opinion: Adhering to Standards of Care Helps Manage Risk
Medicare and other third-party payers have started predicating reimbursement on adherence to standards of care. Post hoc chart reviews have resulted in substantial take-backs for failure to adhere to those values in cardiology, pulmonology and expanding to other areas. Outpatient medicine is also being subjected to such scrutiny. The question of standards and who sets…
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