CMS Finalizes Mandatory Bundled Payment Model

Elizabeth Fassbender; Shreyasi Deb, PhD, MBA

On Nov. 16, 2015, the Centers for Medicare & Medicaid Services (CMS) finalized a plan to bundle payment and quality measures for several lower extremity joint replacement procedures. The Comprehensive Care for Joint Replacement (CJR) model was originally announced in July and would have required participation by nearly all hospitals in 75 geographic areas, beginning Jan. 1, 2016.

What Stage Is Your Marketing?

Bill Champion; Tony Edwards

The recent shift from "volume" to "value" in health care also resonates in marketing your orthopaedic practice. Effective marketing depends on much more than simply ensuring patients see your practice name multiple times in a day or week. Getting the most from your marketing dollars requires ongoing measurements, improved outcomes, and enhanced efficiencies.

Five Tips to Enhance Practice Revenues

In the past, development of a financially successful practice hinged primarily on a physician's clinical expertise, which alone served to attract patients and generate revenue. Nowadays the economic climate is very different. Orthopaedic surgeons must develop new ways to generate revenue while meeting the healthcare needs of their patients. To be successful, practices must generate revenue from multiple sources.

Decreasing Variation in Clinical Practice

Susan T. Mahan, MD, MPH; Donald S. Bae, MD; Rachel L. Difazio, RN, PhD; Peter M. Waters, MD

The current "cost crisis" in health care has resulted in greater emphasis on increasing value in healthcare delivery, particularly in orthopaedics. As orthopaedic practitioners, we are best positioned to streamline musculoskeletal care and to guide changes in practice. Among the many tools that can be used to increase the value of orthopaedic care are Standardized Clinical Assessment and Management Plans (SCAMPs).

Category 1 CPT Coding Update 2016: Imaging Services

Mary LeGrand, RN, MA, CCS-P, CPC

Changes made in the radiology section of Current Procedure Terminology (CPT) coding in 2016 may have an impact on orthopaedic practices, particularly with respect to the possibility of audits. Orthopaedists who submit billing and reporting for imaging services must meet the same standards as radiologists, including a comprehensive report. Twelve new CPT codes were added and several other changes were made to the radiology section (Table 1).

Dealing with Unexpected Medical Outcomes

Michael R. Marks, MD, MBA

The unexpected medical outcome is an issue that all physicians—regardless of specialty—will have to deal with at some point. When that circumstance arises, physicians must deal with it ethically. However, the medical liability laws that apply in the state of practice (or state where the incident occurred) may add to the stress of the situation and the difficulty of the communication.