Rajesh Iyengar

The Anticoagulation Forum is reviewing a proposed CMS quality measure related to the timeliness of VTE diagnosis in primary care during the current public comment period, which runs through 12/30/24. Quality measurement and oversight for thrombosis-related care are critical, and we encourage your organization to review and comment on this measure to help improve patient outcomes. Learn more details on the measure and how to participate in this opportunity here: https://bit.ly/3BF8vwm

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Quick summary of the latest CDC updates to its opioid prescribing guidelines, including 12 key recommendations and 5 guiding principles to aid in implementation https://lnkd.in/eXMdQTHt #opioids #medication #painmanagement #primarycare

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States now have opportunities to improve Medicaid coverage for incarcerated individuals, offering pre-release services & expanding eligibility. This article dissects CMS recommendations, proposing strategies for improved community connection & health care. https://ja.ma/45s4A0x

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➡️ Whether you’ve determined now is the time for you to begin the process toward FACHE or you’re still deciding, the next stop on your journey is our FACHE Overview Webinar. This webinar is free for you to attend but it requires registration. Learn more and register here: https://bit.ly/4fVBYRC

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Wound care folks, I highly recommend reading CMS’ National Coverage Analysis Review (NCAR) document (8/7/2024): https://lnkd.in/ehUWRJfa . The “Methodological Principles” section offers valuable insights into evidence synthesis for coverage decisions. That said, I must take exception to the “Precision of Estimates” section, which states: “Precision is typically judged based on the width of the confidence interval and, more importantly, whether that interval encompasses values that suggest no meaningful effect and values that indicate a meaningful effect.” This is problematic for two reasons: 1️⃣ Confidence Intervals don’t provide probabilistic statements about the true parameter. Instead, they reflect long-run properties of repeated sampling. This is a statement about the data, not the parameter (or population treatment effect). This is a subtle but very important distinction. 2️⃣ Credible intervals (Bayesian) directly quantify the probability of a parameter (or population treatment effect) lying within a range, while Confidence Intervals (frequentist) do not. It’s fascinating—and concerning—that the National Coverage Review relies on Bayesian ideas while using frequentist terminology. This implicit and incompatible blending of frameworks can cause confusion and lead to inappropriate conclusions in wound care, especially with coverage implications like the CAMPS/Skin Sub LCD’s. Open Wound Research

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Value-based care is based in being there for patients every time they need care. In a recent HealthLeaders interview, SSM Health chief clinical officer Stephanie Duggan MD, FACEP, FAAPL, CPE, shares how investing in foundational building blocks is key to creating a successful values-based care model. https://lnkd.in/grxm6fY8

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Practicing Cardiologist, Dr. Samir Damani, gets candid about the financial rewards available to providers implementing remote care, namely CCM and RPM: "Medicare has changed a number of things including reimbursement for the codes, which made it easier to put into action." "As a practice, you can get to the point where you can actually manage this population and be able to pay your overhead, and maybe even make a little extra. And rightfully so, because when these programs are successful, every hospital admission that you've prevented equates to dollars back to taxpayers." https://hubs.ly/Q02zSVkg0

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Health literacy is vital for advancing Medicaid equity. Center for Health Care Strategies latest resource equips healthcare professionals with practical strategies to improve how they communicate with Medicaid members, ensuring patients understand and access the care they deserve. Strengthening these communication efforts helps break down barriers, fosters trust, and leads to more equitable health outcomes. Explore these insights to enhance patient engagement and drive better results in your community.

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Did you know up to 50% of surgical patients experience pain lasting beyond three months? Current management strategies, including opioids, come with risks like addiction and tolerance. This article uncovers the mechanisms driving PPP, highlights key risk factors, and discusses innovative approaches to prevention and management. 🔗 Click here to read more 👉https://buff.ly/3CRqn7e . . . . . #PainSA #PainManagement #MedicalInsights #HealthMatters

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A message from ACPA's Government Affairs Committee Chair, Dr. Ritu Prasad, MD, The Centers for Medicare and Medicaid Services (CMS) and United States Department of Health and Human Services (HHS) have requested 𝐜𝐨𝐦𝐦𝐞𝐧𝐭𝐬 related to 𝐌𝐞𝐝𝐢𝐜𝐚𝐫𝐞 𝐀𝐝𝐯𝐚𝐧𝐭𝐚𝐠𝐞 (𝐌𝐀) 𝐩𝐥𝐚𝐧 𝐝𝐚𝐭𝐚 𝐜𝐨𝐥𝐥𝐞𝐜𝐭𝐢𝐨𝐧 𝐚𝐧𝐝 𝐩𝐫𝐚𝐜𝐭𝐢𝐜𝐞𝐬 𝐝𝐮𝐞 𝐛𝐲 𝐭𝐨𝐝𝐚𝐲, 𝟓/𝟐𝟗/𝟐𝟒.   This request comes particularly timely given the recent final rule 4201-F impacting MA and year-after-year increasing enrollment in MA. The American College of Physician Advisors’ Government Affairs Committee seeks to offer CMS comments to help inform CMS and HHS of our experience with current MA practices, concerns regarding data collection, and to ensure that MA plans provide services to Medicare beneficiaries that are at least as generous as those provided to Medicare fee-for-service (FFS) in a transparent fashion and with decreased administrative burden. 𝐖𝐡𝐲 𝐬𝐡𝐨𝐮𝐥𝐝 𝐲𝐨𝐮 𝐜𝐚𝐫𝐞? ・ More than 50% of Medicare-eligible beneficiaries are enrolled in MA plans and this enrollment is anticipated to continue to rapidly increase. ・ There are ongoing concerns that MA plans continue to offer benefits that are more restrictive than Medicare FFS (via not complying with the Two-Midnight Rule, clinical validation denials, using opaque proprietary restrictive criteria, re-defining coverage benefits as “payment disputes,” laborious prior authorization, etc.). ・ Underpayment occurs frequently for services provided, with significant delays in payment to hospitals. ・ Administrative burden to fight inappropriate denials is at an all-time high. ・ Improved transparency and data reporting from MA to the public is imperative. 𝐀 𝐟𝐞𝐰 𝐡𝐢𝐠𝐡𝐥𝐢𝐠𝐡𝐭𝐬 𝐨𝐟 𝐨𝐮𝐫 𝐜𝐨𝐦𝐦𝐞𝐧𝐭𝐚𝐫𝐲 𝐢𝐧𝐜𝐥𝐮𝐝𝐞: ・ Improved accountability for plans with regards to 4201-F, the Two-Midnight Rule and use of internal coverage criteria. ・ Enhanced transparency and timeliness of prior authorization processes. ・ Proposed guardrails around skyrocketing Clinical Validation Denials by MA plans. ・ Request for a clear centralized process to submit comments to CMS regarding MA plan behavior that is publicly accessible. 𝐏𝐥𝐞𝐚𝐬𝐞 𝐜𝐨𝐧𝐬𝐢𝐝𝐞𝐫 𝐚𝐬𝐬𝐢𝐬𝐭𝐢𝐧𝐠 𝐮𝐬 𝐢𝐧 𝐜𝐫𝐞𝐚𝐭𝐢𝐧𝐠 𝐜𝐨𝐦𝐦𝐞𝐧𝐭𝐚𝐫𝐲 𝐭𝐨 𝐂𝐌𝐒 𝐢𝐧 𝐬𝐮𝐩𝐩𝐨𝐫𝐭 𝐨𝐟 𝐭𝐡𝐞 𝐩𝐫𝐨𝐩𝐨𝐬𝐞𝐝 𝐫𝐮𝐥𝐞 𝐚𝐬 𝐟𝐨𝐥𝐥𝐨𝐰𝐬: ・ ACPA has provided a template to utilize for comment to CMS on this proposed rule, which is attached to this post. ・ Insert your name, organization, a brief description of your experience with MA plans, and closing signature. ・ Go to this website: https://lnkd.in/gQ7S6Gyt to the view the proposed rule and click the option to “𝐒𝐮𝐛𝐦𝐢𝐭 𝐚 𝐅𝐨𝐫𝐦𝐚𝐥 𝐂𝐨𝐦𝐦𝐞𝐧𝐭” to add your comment. 𝐂𝐨𝐦𝐦𝐞𝐧𝐭 𝐩𝐞𝐫𝐢𝐨𝐝 𝐞𝐧𝐝𝐬 𝐭𝐨𝐝𝐚𝐲, 𝐌𝐚𝐲 𝟐𝟗𝐭𝐡, 𝟐𝟎𝟐𝟒. #ACPA #ACPA10 #WeArePhysicianAdvisors #GovernmentAffairs #PhysicianAdvisors

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3 New Guideline Summaries! *CAUTI *Testicular Cancer *BPH Find them here: https://ow.ly/IMbf50RIh42 Use these guideline summaries to stay up-to-date on current recommendations supported by the latest evidence. #NursingResources #Nurses

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Member of the BTF Global Oncology Board Judy Delismon (RN, MN, OCN) wrote an abstract exploring the current state of oncology nursing education at the Binaytara Foundation Cancer Center (BTFCC) in Janakpurdham, Nepal. The abstract describes a pilot program in which "a needs assessment was gathered from seven nurses at the BTFCC. Topics included peripheral IV insertion technique, proper vesicant IV administration, and review of lab values." Read more in the abstract linked here ⬇ https://lnkd.in/gKpkVBZw

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In 27 states and Washington, D.C., NPs have Full Practice Authority, giving patients direct access to primary care providers. States with FPA consistently rank higher in health outcomes—because when NPs can practice fully, everyone benefits! #NPWeek2024 #FullPracticeAuthority

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Women’s healthcare providers should stay updated on the latest guidelines to ensure they deliver evidence-based, high-quality care. Check out our WHNP Guidelines for Practice and Education 8th Edition here: https://ow.ly/5Zri50UCTqf #whnp #cnm #fnp #womenshealth #np #womenshealthnp

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In 2022, the CDC released an updated clinical practice guideline for prescribing #opioids and managing pain in the outpatient setting. This article synthesizes the guideline recommendations and implementation considerations for clinical NP practice. #APRNs #NursePractitioners #PainManagement https://ow.ly/nTJn50TtKsR

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Mark your calendars for June 24 from 12:00 pm to 1:00 pm for a crucial session on "Practical Resources to Support Geriatric Assessment in the Primary Care Setting." Discover best practice clinical resources and assessment tools to aid in evaluating older adults with complex medical conditions. Don't miss insights from expert NPs, Mary Jemmett and Shannon Cadieux. See you there: https://lnkd.in/gEDBn2f7! #GeriatricCare #PrimaryCare #NPEvent #NPAO #NursePractitioner #OntarioNP #Ontario

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