Reimbursement

By Catherine T. Milne, APRN, MSN, BC-ANP, CWOCN

There's a lot to be said about change, and much of what you say depends on which end of change you are on. Those of us who are early adopters of new products, technology or ideas get an adrenaline rush with just the hint of change. We love that feeling of freshness— finding the bumps in the road, meeting the challenges head on and solving the issues at hand. Then we help those who come after us—mentoring them over the hurdles we've overcome as the pioneers in a new territory. We are not early adopters, we are early adapters.

By Dr. Mark Hinkes, DPM

I recently read a synopsis about how Obamacare will affect the type of health care services that will be available in the marketplace and the age groups that will be helped and hurt the most by this new law.¹ Not really knowing much about Obamacare, I read the article and ended up feeling deeply disturbed and shocked at what Mr. Obama and the Congress have unleashed upon us. The news is not good for patients with wounds and for those who practice wound care.

By Aletha Tippett MD

Welcome, Colton Mason, to the WoundSource blog forum. I enjoyed your opening blog on cost versus price and love your Healthcare Caffeine image. You are so correct, looking at overall cost is what is important, not necessarily the price of a product. And it reminds me how we need to look at the whole picture to determine the correct approach for controlling cost

By Michael Miller DO, FACOS, FAPWCA, WCC

As much as I detest bureaucratic oversight and mandates from those above who have no idea what they are doing in their own day to day lest my own, I am coming to the conclusion that a big hammer is needed and fortunately, it seems to be coming. At first, when I heard the whisper that there would be a single amount paid for each wound care case, I shuddered because I was concerned that it would make me look harder at how I spend my patients' money. Diabetic foot ulcer debridements weekly to every other week... going to advanced biologics after the basics have not produced the desired results... tough decisions when economics is the ultimate gatekeeper.

By Lindsay D. Andronaco RN, BSN, CWCN, WOC, DAPWCA, FAACWS

Public policy is an aspect that affects every day practice for most wound, ostomy and continence nurses, but is something that we do not generally think about. One health policy topic that is in the forefront of my mind is how the Centers for Medicare and Medicaid Services (CMS) is looking to change the process for how patients access or DME products. This change in public policy would affect the access of these necessary products to our patients.

By Colton Mason

I love coffee. I often joke with my friends that drinking coffee is the only way I can get my eight glasses of water in every day. Now if you're a coffee junky like me, you can probably tell the difference between a great cup of coffee and one that's just so-so.

By Thomas E. Serena MD, FACS, FACHM, FAPWCA

The Black OPPS continues unchecked. My last blog addressed the recent Centers for Medicare Services (CMS) outpatient prospective payment system (OPPS) in regards to cellular and tissue-based products (CTPs). In the blog, I bemoaned the fact that CMS ignored the prevailing evidence for CTPs in assigning reimbursement for the various products pricing a couple of the living tissues with the most robust evidence on the market. Many of you requested our policies on CTPs, however the algorithm has changed almost daily since the beginning of the year. You will have to wait I'm afraid. In the interim, this month we will examine the change in facility payments.

By Thomas E. Serena MD, FACS, FACHM, FAPWCA

Resting peacefully by the fire, eggnog in hand, wearied from stringing lights and eleventh-hour shopping, I settled in for the evening. My eyes lazily perused the laptop screen when the news bulletin shattered my serenity. The Centers for Medicare Services (CMS) had sabotaged the evidenced-based pyramid in the field of wound care. Our fragile edifice of evidence crumbled under the weight of the "Black OPPS." Sequestered beneath a mountain of digital output, which took hours to dig through, lay a new categorization of the most commonly used advanced wound care modalities: Cellular and Tissue-Based Products (CTPs), formerly called "skin substitutes."

By Michael Miller DO, FACOS, FAPWCA, WCC

RAMBLINGS OF AN ITINERANT WOUND CARE GUY, PT. 17

It has been said that even a blind squirrel finds a nut once in a while. Like Isaac Newton who discovered gravity courtesy of an apple hitting his noggin and Ben Franklin discovering electricity by flying a key laden kite into a Philadelphia storm, even lowly rambling wound care guys trip over the truth. So many questions and so few answers until…there amongst the trees appears a forest. And so, in the spirit of the Indianapolis Colts finding a diamond in Andrew Luck, I am pleased to announce that I have recently identified the presence of a multi-tribal primitive species existing amongst us. Based on their aberrant business behavior, their ability to masquerade as Homo sapiens, their will-o-the-wisp flashes of humanity (interspersed with maniacal idiocy) and their unquenchable thirst for complexity and deception, I have proudly named them after our current governmental medical overlords.

by Paula Erwin-Toth MSN, RN, CWOCN, CNS

Part 3 in a series discussing the challenges and opportunities in patient/family education
For Part 1, Click Here
For Part 2, Click Here