2017 was the first year for participation in the Merit-based Incentive Payment System (MIPS), a Quality Payment Program (QPP) implemented by CMS, to award or penalize participating clinicians with regard to future Medicare reimbursements based upon reporting under four categories:
A 2016 report from the Centers for Disease Control and Prevention (CDC) found that 20 percent of Medicare participants 65 or older don’t take their blood pressure medicine as directed.1 Additionally, 20-30 percent of prescriptions for chronic health conditions are never filled and roughly 50 percent are not taken as recommended.1
Studies have shown that almost 9 out of 10 adults have difficulty using the health information they receive. This difficulty reflects a gap in patients’ capacity to obtain, process, and understand basic health information and the services needed to make appropriate health decisions. In other words, the studies reflect a gap in health literacy.
It’s been more than twenty years since the 1997 revisions to Evaluation and Management guidelines, which focus mainly on physical examination. The 2019 proposed changes provide practitioners a choice in the basis of documenting E/M visits; alleviate the burdens, and focus attention on alternatives that better reflect the current practice of medicine. The implementation of electronic medical records has allowed providers to document more information, yet repetitive templates, cloning, and other workflows have pushed the envelope on compliance in documenting the traditional elements of the visit.
One of the most frustrating things PC users can experience is slow performance or freezing while using their normal programs. It can make even the simplest tasks take several times longer and greatly slow down your work day, which impacts patient care as well. While it will sometimes mean there could be hardware issues and your PC needs an upgrade, there are several steps that you and your IT support can take to speed up the performance of your PC through cleanup tools, anti-virus and anti-malware scans, or optimizing settings.
What is the importance of occupational and physical therapy rehabilitation? Each discipline has its own unique benefits for clients of all age ranges with varying diagnoses and various settings. A common misconception regarding therapy in general is that treatment will elicit pain and discomfort. However, one of the primary goals of both occupational and physical therapy is to control pain in order to increase daily function and skill.
Children’s of Alabama in collaboration with the Anne B. LaRussa Foundation of Hope launched a new service in March 2018 targeting patients, families and providers who seek better access to mental health care resources. The Psychiatric Intake Response Center, or PIRC, located in Children’s Emergency Department, is staffed by licensed mental health clinicians who, via telephone or in person, assess a child or adolescent’s mental, emotional and behavioral needs, and recommend the best treatment options.
I find it intriguing that physicians are one of the only professionals who pledge an oath before practicing their craft. Other notable “oath” moments in our country focus mainly on Nationalism and Service (Military, Law Enforcement, Public Servants and Naturalization among others). How different might some professionals behave, if included in their daily duties, was the acknowledgement that they are working under an assumed set of values and principles that help guide their tasks? For CERTIFIED FINANCIAL PLANNER™ professionals this exists, not in an oath form however; but within principles expressing ethical and professional ideals.
One of the greatest challenges facing the healthcare industry isn’t a political issue, it’s a geographic issue. What if I told you that approximately 50 million Americans (17 percent of the total population of the US) have limited access to high quality healthcare because they live in rural communities? Rural healthcare has a unique set of challenges including not only geographic but also economic and lifestyle factors.
Those of us who live in the South are pretty familiar with hot weather, but as we get into the dog days of summer, the heat can become excessive and oppressive. All the normal rules for heat and sun safety apply, but as temperatures soar, you may need to take more extreme measures to stay cool and safe.
Other than skin cancer, prostate cancer is the most common cancer in American men. Although it is common, it is still one of the least well-known cancers and a diagnosis can cause confusion about treatment, symptoms, and potential side effects. In search of a minimally-invasive treatment for your prostate cancer? Through our partnership with Vituro Health, Urology Centers of Alabama is the first and only in the state to offer High Intensity Focused Ultrasound, or HIFU treatment.
I recently visited a specialty practice at a major health system. As I approached the registration desk a posted sign directed me to a standing kiosk to sign in. The family member I accompanied to the visit was unable to stand at the kiosk, so I provided the needed information and signed her in. Although it was a quick and seamless process, I was concerned because if I needed assistance, there were no employees to ask. Many practices have implemented kiosk sign-ins and have someone to assist a patient with the process if needed. Practice administrators have made the decision to implement kiosk to assure verification of the current insurance policy and prompt the patient to pay any out of pocket expense before they see the doctor. Many of the kiosk solutions allow a pre-registration via email to allow the patient to populate data and upload information from their own device at their convenience. Benefits of Kiosk Sign-ins include: reduction in the staffing at the front desk, decrease in patient wait time, and most impressively is the increase of time of service collections.
Medical advancements through specialized programs and essential personnel are vital to the continued growth of the University of Alabama at Birmingham (UAB) Division of Pediatric Neurology at Children’s of Alabama. Expansion is underway while the unremitting needs of patients are met.
The CDC estimates that 1.2 million people in the United States have chronic Hepatitis B (HBV) but two-thirds do not know they are infected. These unaware patients can have clinically silent infections for decades until developing cirrhosis, end-stage liver disease, or hepatocellular carcinoma (HCC). HBV is transmitted by percutaneous or mucosal exposure to blood or body fluids of an infected person, such as from an infected mother to her newborn during childbirth, through close personal contact within households, through unscreened blood transfusion or unsafe injections in health- care settings, through injection drug use, and from sexual contact with an infected person.
The question is often asked, at what point should a patient and his or her physician begin to consider a total joint replacement?
It is especially important for smaller practices to be mindful of Electronic Protected Health Information (ePHI) security regulations – a breach of ePHI can lead to costly notification requirements and potential monetary penalties under the HITECH Act. Managing physicians of small independent practices hold many responsibilities, including the duty to comply with the Security Rule within HIPAA regulations. This article provides a brief overview of federal ePHI compliance safeguards required in a practice. While not meant to be a comprehensive discussion of all requirements, it highlights legal considerations and safeguards a practice must implement to comply with HIPAA ePHI regulations. The federal Security Rule under HIPAA requires a health care provider (typically known as a Covered Entity) to have the minimum ePHI safeguards, listed below.
As today’s healthcare drive pushes practices even further down the path of pay for performance versus the older models of pay for volume, administrators and executives throughout healthcare are researching and implementing ideas to provide an overall better experience for patients.
Pelvic organ prolapse (POP) is the descent of one or more parts of the vagina and/or uterus. Woman may experience displacement of the anterior, posterior or apex of the vagina, and often there is a combination. This is referred to as a cystocele, rectocele and enterocele.
According to a recent study by the Cleveland Clinic, more than one-third of physicians are in a silent battle with professional burnout. Physicians dealing with mental, emotional and physical exhaustion become less able to provide quality care to their patients and find themselves leaving the medical profession altogether…or worse. It’s the “or worse” scenario that worries Dr. Debbie Kolb of Madison.
Are you sleeping well? One in three Americans suffer from sleep-related issues. If you or someone you know suffers from a sleep disorder, there has never been a better time to find a solution. Lack of good sleep can be detrimental to one’s quality of life in many aspects. Untreated sleep disorders make it difficult to control other health conditions such as migraines, anxiety, depression, pain, and more. Poor sleep due to a disorder such as sleep apnea can also have negative effects on your social life, as you are too tired to participate in social activities. People who snore could also interrupt the sleep of their bed-partners! Finally, sleep issues can lead to poor concentration, job performance, and lack of productivity.
In 2012, I read this that made me question much of what I thought I knew about my profession of serving clients as a guide for their financial decisions. The designation following my name for which I had worked so hard at obtaining? Good, but not enough. The incredible technology –from complex financial forecasting to automated investment management? Lacking.
On Friday, January 19, 2018, the Department of Health and Human Services (HHS) issued a proposed rule that will complicate the issues healthcare providers face in providing treatment to LGBTQ patients.
Lipedema (Lip- fat, edema- swelling) is a disease of abnormal and disproportionate adipose tissue deposition almost exclusively occurring in women1. While the disorder was originally described in 19402, lipedema remains under-recognized and underdiagnosed in the United States3. This article aims to elucidate the salient features of lipedema toward the goal of raising awareness among the medical community.
2018 marks 23 years since Children’s of Alabama entered the primary care market, expanding our footprint and brand awareness outside of our main campus on Birmingham’s Southside and strengthening our relationship with doctors who care for kids.
They were surprised, and you likely be will, too. Of the hundreds of healthcare organizations I’ve helped document HIPAA and meet compliance requirements, most are unaware that their Patient Health Information (PHI) is exposed in some way. If a cyber attacker took advantage of this situation, it could cause damage to your patients, bring giant HIPAA fines, and a loss of reputation.
A rare cancer of the eye known as uveal melanoma has affected a specific demographic, mainly women, who attended Auburn University in the late 1980’s and early 1990’s. Uveal melanoma is the most common cancer in the eye, but overall its incidence is extremely low, known to affect only 4.3 per 1 million people in the US. While these cancers are uncommon, they can lead to unfortunate outcomes including total removal of the eye, and even aggressive cancers spreading throughout the body, making it crucial to catch them early.
The new tax reform law — commonly referred to as the "Tax Cuts and Jobs Act" (TCJA) — is the most significant tax legislation in decades. Although the law was passed only a few weeks ago, the impact on the economy and business outlook cannot be overlooked as the stock market rally continues and both individuals and businesses appear the most optimistic in quite some time.
Birmingham, AL – Behavioral Health Systems, Inc. (BHS), a Birmingham-based corporation administering national behavioral health programs since 1989, will be hosting a national economic and legislative forum on Wednesday, April 18, 2018 at The Club in Birmingham, from 8:00 am to 5:00 pm.
At the core of the Affordable Care Act (ACA) is the three-legged stool: (1) insurance reforms; (2) the individual mandate; and (3) premium and cost-sharing subsidies. Removal of any one of these legs could destabilize the ACA. The ACA established insurance marketplaces in every state to provide access to ACA compliant private health insurance coverage (Qualified Health Plans) in the individual and small group markets. The ACA provides premium subsidies on a sliding scale for persons with incomes up to 400% FPL for the purchase of an individual policy on the marketplace exchange. It also provides cost-sharing subsidies for persons with incomes below 250% FPL. Prior to the implementation of the ACA, manual rating was typically used by insurers for rate-making in the individual and small group markets and exclusions from coverage for pre-existing conditions were common. Age-based rates were typically 5:1. The insurance reforms in the ACA are largely directed at the small group and individual markets (e.g., guaranteed issue/renewal, no preexisting condition limitations, adjusted community rating capped at a 3:1 ratio for age). Standardization of benefits is achieved by requiring coverage for ten essential health benefits (EHBs) and certain preventive services which in the latter case services must be provided without cost-sharing.
Physicians and other medical care professionals spend years studying, training and preparing themselves to provide best possible care to their patients. In many instances, these professionals spend the bulk of their attention and energy on treating their patients and meeting the day-to-day challenges that come with providing the best care possible. Unfortunately, practicing in today’s economic climate within a medical industry undergoing a vast transformation has forced many medical professionals to place equal value on business issues that effect their practice. Often times, the business of operating a medical practice is never discussed in medical school. Instead, many healthcare professionals are forced to learn fundamental business principles on the fly in private practice. With the emergence of electronic medical records and coding, many healthcare providers and practices are spending a substantial amount of time concentrating on the business of healthcare in addition to patient care. Of all the business issues that must now be prioritized by the medical industry, medical billing and managing account receivables can bear the most burden of all.
The assessment of patient compliance is very difficult. Many patients may not want to disappoint their physician and will not be completely accurate about their degree of compliance. Other patients are not able to accurately evaluate or do not know their degree of compliance. In one study, 10% of patients reported that they were 100% compliant with their medication use. Using pill count methods, however, the use of the prescribed medications ranged from 2% to 130% of the prescribed pills.
Until recently, sufferers of chronic or recurrent sinusitis were limited to two treatment options: medication therapy or aggressive sinus surgery. Fortunately, advances in medical science have opened new doors.
Physicians serve on the frontlines of our healthcare system, and by extension the many social programs guaranteed by the Social Security Administration. It’s a large responsibility and we owe them a debt of gratitude. These dedicated care providers, across many areas of practice and at varied levels within our medical system, help more than 57 million children and adults who live with disabilities across the United States.
We hate to break it to you, but there's a HIPAA requirement you’re more than likely doing wrong. The Department of Health & Human Services’ Office for Civil Rights (OCR) is cracking down on requiring a true
We all recognize that healthcare is evolving at a rapid pace. With this evolution, the need to share patient information to positively impact quality care, provide a seamless patient experience, plus save time for your staff to coordinate care is of critical importance. By making the most of new technology, today’s office equipment can easily and securely, help you do just that.
Noncompliance (non-adherence) to medical recommendations can have a significant impact on a patient’s overall health quality, resulting in decreased opportunities for prevention, delayed diagnosis, and incomplete or ineffective treatment. There may also be significant liability and financial risks to a responsible healthcare professional treating this patient, particularly as patient outcomes increasingly become connected to quality indicators and reimbursement.
The Alabama Center for Childhood Cancer and Blood Disorders at Children’s of Alabama actively works toward the goal of a total cure through research and development of innovative therapies. More than a dozen prominent pediatric hematology, oncology and blood and bone marrow physician-scientists provide exceptional programs in patient care, education and research. Currently, the Center provides care or treatment for 90 percent of the pediatric hematology-oncology patients in the state.
Dr. Sunshine arrives in her clinic at 8 am. Her lobby is full of patients. Mrs. Jane, a 45-year-old widower who has been Dr. Sunshine’s patient for 10 years. Mrs. Jane has recently been complaining about reoccurring back pain, the inability to fall asleep, and indigestion problems. Dr. Sunshine is aware of the sudden passing of Mrs. Jane’s husband a year ago and treats her physical symptoms as they present themselves with analgesics, sedatives and reflux medicine. Yet, Mrs. Jane’s complaints remain. Although compliant with her medications, Mrs. Jane’s symptoms are a result of Major Depressive Disorder.
Just because you’re getting older doesn’t mean that it’s too late to get in shape. In fact, research shows that older people who have never exercised can still benefit from physical conditioning. By starting a regular exercise program, you can help prevent coronary artery disease, high blood pressure, stroke, diabetes, depression and some cancer. Physical fitness reduces the effects of osteoporosis and arthritis — two conditions which can severely limit an older person’s lifestyle. Being in good shape physically can help you remain independent as you age and improve the quality of your life.
As we finalize 2017 participation in the Merit Based Incentive Program, most of us focused on improved performance in quality since the category carried the highest weight of 60%. Those who had previous success in Meaningful Use found the Advancing Care category easy to address. The Practice Improvement category is new and somewhat vague, but many practices were already performing tasks that qualified as an improvement activity. It is important to document the approach to improvement and track success because this category is subject to audit in the future.
Approximately 12 million Americans suffer from peripheral artery disease (PAD), yet general awareness of the disease is at 25%. Patients over the age of 50 with a history of smoking, high cholesterol, diabetes, hypertension, and heart disease are at the greatest risk. A staggering 50% of PAD patients have unrecognized symptoms that may progress directly to severe disease.
Full scale recruitment is under way for the Alabama Genomic Health Initiative (AGHI), a partnership of the University of Alabama at Birmingham (UAB), HudsonAlpha Institute for Biotechnology and Children’s of Alabama. Funded by a $2 million appropriation from the Alabama legislature to UAB, the AGHI is one of the nation’s first statewide efforts to use genomic analysis to identify those at high risk for genetic diseases.
What is myopia?
Myopia is a condition that results in distant objects appearing blurry to a patient when not being corrected with glasses or contact lenses.1 Myopic blur typically results from the eye being too long for its optical focusing components (cornea and crystalline lens), which causes distant objects to be in focus in front of the retina (back of the eye) instead on the retina, a requirement for the eye to be able to see clearly.1 About one third of Americans have myopia, and its prevalence is likely increasing because of factors associated with living in a developed country (e.g., decreased time outdoors).2-5 With that said, the scientific community only has a vague understanding of how genetics and the environment influence the development and progression of myopia.1 While myopia’s visual affects can be a costly nuisance and strain on the health care system,6 myopia also places the affected individuals at a greater risk for developing vision-threatening conditions like cataracts, retinal detachments, and glaucoma.1 Once present, myopia cannot be cured; therefore, preventing it or even reducing the amount of myopia that a patient develops is an upmost priority for the scientific community.7
For 2017, The American Cancer Society has estimated that around 252,710 new cases of invasive breast cancer will be diagnosed in women and 2,470 diagnosed in men, around 63,410 new cases of Carcinoma in situ(non-invasive and the earliest form of breast cancer) will be diagnosed, and approximately 40,610 cases will be fatal.
Over 36 million American adults have some degree of hearing loss.
That is over 4 times the amount of people who live in New York City.
As of September 30, 2017, the Department of Health and Human Services Office of Civil Rights (OCR) has received notices of 237 breaches. 46% occurred as result of hacking or IT security incidents; many at the business associate level. Ransomware is rampant and projected to increase 670%. As a covered entity, although a breach occurs at your business associate, under HIPAA, you are responsible for your protected health information and responding to the breach. OCR has been clear that breaches of 500 or more records will be investigated. Given the significant increase in breaches over the past few years, advance preparation is critical and can reduce the cost and burden of breach response.
An Oklahoma physician agreed on August 28, 2017 to pay the government $580,000 to resolve allegations that he violated the False Claims Act by submitting claims to the Medicare program for services he did not provide or supervise. According to the government, the physician allowed a company that employed him and in which he had an ownership interest to use his NPI numbers to bill Medicare for physical therapy evaluation and management services that he did not provide or supervise. The government further alleged that after he separated from the company and deactivated his NPIs associated with the company, he reactivated those NPIs so that the company could use them to bill Medicare for services he neither performed nor supervised.
Did you know a single patient health record can earn cybercriminals 10 times the price of a stolen credit card number on the black market?
The Office of Civil Rights is auditing small and large healthcare providers alike, imposing multi-million dollar fines in some cases. Meanwhile, the same electronic storage, mobile devices, and cloud-based applications that patients, doctors, and healthcare staff want to use often compromise a practice’s ability to keep that patient data safe.
Did you know that prostate cancer is the second most common cancer among American men? In fact, an average of 480 American men are diagnosed with prostate cancer every day - that’s one every 3 minutes.
It has now been two years since the implementation of ICD-10, everyone survived! While denials have been minimal, the goal of implementing ICD 10 to acquire more specificity and a complete picture of health has not been fully achieved. Physicians and managers have created a new set of shortcuts to assure payment of claims, relying on paper superbills or inappropriate conversions from ICD 9 to ICD 10.
Albert Einstein once said, “Life is like riding a bicycle. To keep your balance, you must keep moving.” Moving is one thing the City of Opelika is determined to do…even on two wheels.
Tumor Treating Fields or TTF as it is more commonly known is a recently developed method by which malignant brain tumor cells are prevented from reproducing. Shelby Baptist Medical Center and Generations Radiotherapy & Oncology PC has begun therapy on its first patient using this entirely new approach in the treatment of malignant brain tumors with the Optune TTF system.
Prostate cancer is the second most common cancer diagnosed in American men and the second leading cause of cancer death. While a majority of men will be diagnosed after the age of 65, younger men do need to consider screening for prostate cancer, especially if risk factors are present such as African American heritage or a family history of prostate cancer.
The city of Marion is an old town rich in Alabama history that pre-dates the Civil War. It’s home to many antebellum homes, Judson College and Marion Military Institute, the nation’s oldest military junior college. Few people may know that a young Coretta Scott, born and raised in Marion, wed her husband, Rev. Dr. Martin Luther King Jr., on the front lawn of her mother’s home just north of Marion in 1953. It’s this small town’s amazing history that called out to Dr. Shane Lee when he was looking to set up a practice.
Between 2000-2015 the number of Americans with hearing loss has doubled, bringing it close to 48 million. With the aging baby boomer population, that number will continue to climb in the coming years.
On June 20th, CMS issued its proposed rule for year 2 of the Quality Payment Program (QPP) under Medicare Access and CHIP Reauthorization Act of 2015( MACRA). Comment period ends August 20.
The AAOS (American Academy of Orthopaedic Surgeons) has recently sponsored some remarkable multimedia public service campaigns. You may remember the recent “Decide to Drive” initiative about distracted driving /texting. Well, their newest is “Painkillers are easy to get into. Hard to escape.” Included in the AAOS statement, the U.S. Department of Health and Human Services reports on an average day in the U.S., more than 650,000 opioid prescriptions are dispensed and 78 people die from opioid-related overdose. It is considered an “epidemic.” We all have relatives, friends, and patients who have been caught up in and succumbed to the detrimental effects of drug addiction.
For years now, I have seen patient after patient frustrated with stubborn fat in areas that do not respond well (or quickly) to diet and exercise. Their concerns are very common, and certainly not something of which to be ashamed. Patients also frequently ask me for my recommendations on non-invasive cosmetic treatments designed to address these issues, like CoolSculpting®, Sculpsure®, Vanquish™ or Zerona™.
The Mobile area has many sites for tourists to visit during a stay. From the Gulf Coast Exploreum Science Center & IMAX Theater, the USS Alabama Battleship, the beautiful flowers of Bellingrath Gardens, dipping your toes in the warm Gulf waters of Dauphin Island, to celebrating Mardi Gras at the Mobile Carnival Museum, there’s one attraction in Mobile that may not immediately catch your attention, but you surely should not miss…the Mobile Medical Museum.
Summer is quickly approaching, a season that usually comes with warmer weather and, for many of us, vacation time. Vacations come in a variety of forms. You may prefer a staycation where you simply stay at home and avoid emails for a week. You may favor an once-in-a-lifetime trip to a place like Iceland, or you might head to the southern Alabama coast to catch some sun at the beach. While the travel possibilities are nearly endless, a contact lens wearer needs to be prepared for every situation.
A family medicine doctor is someone you can always feel comfortable voicing your concerns to and leave an appointment feeling as though you were really listened to. They will help you to become an informed and active member of your healthcare decision-making process.
As we approach the beginning of summer, our minds are likely not on summer vacation. The process of assessing our electronic medical record vendor, absorbing the details of MIPS, and making the decisions on how to prepare, is overwhelming for small practices. The transition to value based medicine has been evolving over the last 10 years in stages; adopting electronic health record, Quality Reporting, and Meaningful Use. Many administrators and physicians did not realize the importance of each project; from choosing the right EMR, to implementing it properly, therefore achieving best practice workflows.
Physicians Giving Back with Lee Irvin, M.D.
You probably don’t know Lee Irvin, M.D., of Mobile, and he’s fine with that. He’s the kind of gentleman you’d love to hang out with and have a drink or dinner with…swap stories with. But it’s easy to see that his medical mission over the last couple of years wears heavy on his heart.
You may have thought that a sports orthopaedic center would be a place to go only after a catastrophic sports injury—something breaks or tears or starts hurting so badly you can’t physically use it.
“Most athletic injuries seen in sports clinics are indeed overuse injuries that have reached a point of taking the patient out of the game,” said Dr. Ricardo Colberg of Andrews Sports Medicine & Orthopaedic Center. “Although 85% of sports injuries do not require surgery, many patients wait until they are unable to compete to start correcting their issues.”
As pediatric medicine becomes more specialized, the demand for specialists grows. One need look no further than the Division of Pediatric Neurology at the University of Alabama at Birmingham (UAB) for evidence of this trend.
As we women age, we do not always know what is coming next. We think we do, but we may not. We all know the stereotypical changes that happen with menopause, and of course, chronic diseases such as diabetes, heart disease, etc. that can occur with age. I can tell you that many women in their late 40s to late 70s are not expecting pain with intercourse, vaginal pain and discomfort, or both. It is honestly a surprise. And not a good one at that. It can make a healthy sexual relationship go sour very quickly, which not only hurts the woman’s quality of life, but her partner’s as well. This can affect the relationship as a whole, and both parties’ overall health, which can then lead to other medical issues. In our practice, we traditionally have treated men for erectile dysfunction and other sexual issues, but we understand that female sexual health is important as well.
MONTGOMERY – On March 29, officials from the Medical Association of the State of Alabama participated in a proclamation signing ceremony declaring March 30, 2017, the Second Annual Doctors’ Day in Alabama formally recognizing Alabama’s nearly 17,000 licensed physicians serving millions of residents through private practice, in hospitals, in research, and in other health care facilities.
2 pounds asparagus 1 spring onion or scallion (thinly sliced) 1/4 cup extra virgin olive oil 4 hard boiled eggs (chopped) 1/4 cup toasted breadcrumbs 1/4 grated parmesan
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