Articles related to INSURANCE

The merit-based incentive payment system (MIPS), which adjusts clinician Medicare Part B payments for performance on quality, cost, improvement activities, and use of certified EHR technology for interoperability, along with EOM quality measurement systems for Medicare, should ideally be meaningful to physicians and patients and coordinated to magnify the quality signal. How do these novel methods compare, then, in terms of genuinely comprehending the standard of cancer care provided to Medicare beneficiaries?

For some of the most often applied treatments for meibomian gland dysfunction (MGD), such as imaging, exfoliation therapy, heat therapy, strong pulsed light therapy, and meibomian probing, Myranda Partin, OD, offers advice, coding, and reimbursement information.

According to a survey conducted by the Association for Clinical Oncology, the majority of respondents (96%) said prior authorization has led to delays in cancer treatment, with 80% claiming prior authorization has enabled disease progression, and 36% of them saying prior authorization has led to patient deaths. 300 ASCO members who work in academic or university (29%) settings, private practice (34%), or community or hospital-based health network/systems (35%), completed the survey.

A video conversation between a senior advisor at ADVI, a physician from Texas Oncology, and the division director of practice health for ASCO discuss the main provisions of the Inflation Reduction Act (IRA) and its implications for oncologists and oncology practices. The panel discusses why practices may have to bear a larger share of the cost of drugs and be ready for utilization cuts by focusing on two important aspects of the IRA: the $2,000 cap on patients’ out-of-pocket expenses and Medicare price negotiation. All three concur that if the act isn’t changed, it might slow down the development of medicines for some indications.

A cohort study of 1,024 patients at an urban academic medical center discovered that 13% of oral anticancer drug prescriptions were never filled. The most common reason for failure to receive an oral anticancer drug prescription was due to patient and clinician decision-making; 13% of cases of failure to receive an oral anticancer drug prescription were directly associated with financial access issues.

With regard to his panel, “DSM-5 Text Revision (DSM-5-TR): What’s New and What’s Different,” which was presented at Psych Congress Elevate 2022, Michael B. First, MD, professor of clinical psychiatry at Columbia University in New York City, and editor and co-chair of the DSM-5-TR, responds to questions in this Q&A. The updated text’s main revisions to the “Introduction” and “Use” sections are discussed by Dr. First, who also explains the new diagnoses it now includes and provides his thoughts on how the enhanced text will help psychiatrists in their daily work.