WE ARE 21! EDITOR
WE ARE 21!
Over these years, we have grown: we gained experience, earned a reputation, developed our own software, and even launched a franchise.
That's why we are pleased to start this new year with the release of our renewed Newsletter. Meet top doctors throughout the world. Get the latest information about technical and scientific innovations. Stay up to date with worldwide healthcare news. Keep an eye on podcasts with professional analytic opinions. Simplify your choice with medical product reviews. Find the most unexpected discounts with our coupons. We are sure you will love the changes. We want to make WCH Insights your adviser and friend. To make it more valuable for you, we will change our format, going beyond the habitual frames. And only our assistance will remain unchanged in this fast-changing world. Our creative team finds life vibrant and engaging: there is so much to know and learn!
We cannot wait to share that with you!
We invite you on a fascinating journey through our pages. Let's learn new things together!
WE HAVE COME A LONG WAY, BUT WE WILL NOT STOP HERE!
The right time to get better is always now.
Yours respectfully, Iryna Tetera, Editior in Chief
OVERCOME ACP PROBLEMS WITH
SOME SIMPLE MEASURES
As per a new OIG report, Medicare’s Advance Care Planning (ACP) experienced a bumpy ride during the pandemic. Basic mistakes by the providers are the primary reason behind them.
The ACP service has been payable since 2016 through a 30-minute code 99497 and an add-on code 99498. It was observed that between the years 2020 and 2021, code 99497 grew by 10% (after the fall in 2019) whereas the use of 99498 went down.
OIG discovered that the reason behind the problem is simple ignorance of ACP billing by the providers. Some cited error types were:
• Failure to distinguish the time spent: Many providers documented the ACP service but did not distinguish between time spent face-to-face with the beneficiary and time spent on concurrent services.
• Discussion not documented: As per OIG findings, in several cases, the code was billed properly, but providers did not document the medical records that an ACP discussion occurred.
• Reasons for multiple sessions were not included: CMS’s FAQs section specified that “when the service is billed multiple times for a given beneficiary, we would expect to see a documented change in the beneficiary’s health status and/or wishes regarding his or her end-of-life care.”
OIG found an instance where a provider attached a separate ACP charge to 26 claims for a patient’s follow-up or medication refills with no documentation or reason.
Three ways to get more ACP
EDUCATE AND SUPPORT PATIENTS: Healthcare providers should play a pivotal role in educating and supporting patients in ACP by asking the right questions about the goals of care, sharing information about various post-acute care options, and opening the door for patients and their families.
GET EXPERT ADVICE: If providers do not feel confident about approaching the subject with patients, they should seek guidance from postacute care partners that are experts in the space.
REVIEW THE RULES:
The OIG suggests providers read the CMS FAQs and the related MLN Fact Sheet regularly to know the nitty-gritty of ACP. The more they know, the more comfortable they are with the process.
At present, a broad range of qualified health personnel can perform ACP services, but only physicians and other providers working within their state scope of practice can bill for it directly. But there’s a movement afoot in Congress to expand Non-Physician Practitioner (NPP) eligibility at the federal level.
AHEAD OF THE CURVE
GLOBAL MORTALITY ASSOCIATED WITH 33 BACTERIAL PATHOGENS
Reducing mortality from infections is clearly one of the global public health priorities. Earlier studies have estimated the deaths associated with drug-resistant infections and sepsis. The conclusion was: infections are still the leading cause of death worldwide.
Recently The Lancet published a study funded by Bill & Melinda Gates Foundation, Wellcome Trust, and the Department of Health and Social Care, using UK aid funding managed by the Fleming Fund. Probably, it is the first study that presents global comprehensive estimates of mortality due to 33 bacterial pathogens in 11 major infectious syndromes. After all, understanding the global burden of common bacterial pathogens is vital for finding out the greatest threats to public health.
HIV EPIDEMIC IS GROWING IN PAKISTAN
Pakistan is one of the few countries in the Asia Pacific Region where new HIV infections are rising. Because of the increase in diagnoses, experts have legitimate concerns that the disease could spread to the masses.
Between 2010 and 2022, this growth was 84%. On the one hand, experts admit that one of the reasons for the sharp increase may be related to more tests, but on the other, it does not make the situation any less frightening.
Even though new HIV infections are increasing in all four of Pakistan’s provinces, most patients live in just two of them. The epidemic remains largely concentrated in key populations, including people who inject drugs, the transgender community, sex workers, and men who have sex with men. But the studies in 2019 show that the number of cases when disease transmissions from key to bridging populations (spouses, partners, and clients) are on the rise. From April to December, 2019, more than 800 children and 200 adults tested positive for HIV. This increase was triggered by unsafe injections and poor blood safety in medical facilities. Steps have been taken, but the demand for blood experiences is still great, and people still go to unregistered places.
Unfortunately, at this time, only 21% of people living with HIV in Pakistan are aware of their status, and just 12% are on treatment.
New initiatives should be piloted, including pre-exposure prophylaxis for HIV prevention (PrEP), HIV self-testing, and opiate agonist therapy, and education about PrEP and HIV testing services is crucial.
NEW DISCOVERIES IN THE FIELD OF BRAIN CANCER IN DUBLIN
Three New Subtypes of Brain Cancer Were Identified at RCSI University of Medicine and Health Sciences in Dublin. They are all a type of glioblastoma.
This discovery is vital, as these subtypes can help to identify new, effective therapies. Currently, the cause of most glioblastomas is unknown. Genetic disorders, such as neurofibromatosis and Li–Fraumeni syndrome, as well as previous radiation therapy are potential risk factors.
Studies have shown that glioblastoma can be placed into three categories based on the different kinds of non-cancerous cells found within the tumor.
At the present time, most patients with glioblastoma receive the same treatment. The discovery, however, will make it possible to apply for precision medicine. That means that patients will receive treatment specific to the cells in their tumors.
Precision medicine could include the use of immune-targeting therapies in patients with a tumor subtype defined by high levels of immune cells within the microenvironment of their tumor. Moreover, the data has already shown that this approach has improved outcomes compared to others.
T HE D OCTOR WHO GIVES PATIENTS THEIR FACES BACK
Polish innovator Adam Maciejewski was the first surgeon in the world, who provided life-saving face transplantation.
Performing complex surgeries on the face and organs of the neck and head, professor Adam Maciejewski returns the function of the damaged organs and images to cancer and trauma patients. Journalists from all over the world used to call him a magician, but Adam said, «I’m just trying to do my job as well as possible, and this success is not only my credit but the credit of all my team.
Adam’s father is a well-known and respected oncologist, but the choice of profession for his son was almost accidental. Adam was involved in tennis and skiing. Studying seemed to him even more tedious. But that all changed at the surgical internship. Adam was fascinated. He started to spend all of his time at the hospital, even on weekends and vacations.
Despite his busy schedule, Adam found time to answer a few questions exclusively for WCH Insights.