A Systematic Approach to Expense Reduction Analysis

Daniel H. Friend, MBA, PhD, CMPE

In today's healthcare world it is more important than ever to "manage expenses." The typical practice administrator is constantly looking for ways to cut costs. However, these tasks are usually performed on an ad hoc basis without a scientific, analytical approach. A spreadsheet that can be used to systematically review every area of a practice and to create a game plan to manage potential expense savings would certainly help.

That Was Then, This is Now

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

Over time, coding recommendations or payer rules, including Medicare payer rules, change or are clarified. This article addresses a coding issue originally covered in the February 2014 issue of AAOS Now. Modifier 59 denials' Q. The local Medicare carrier has recently denied multiple claims with the same Current Procedural Terminology (CPT) code reported more than once, using modifier 59 to indicate that the second procedure was performed at a different location.

Understanding the Implications of MACRA

John Cherf MD, MPH, MBA

On April 28, 2015, a piece of legislation often referred to as the "SGR repeal law" was signed. This bill, the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) permanently eliminated the Sustainable Growth Rate (SGR) formula. More importantly, the law made significant changes to the way Medicare will pay physicians and accelerates a shift to value-base payments. These changes will have a lasting impact on all healthcare providers, including orthopaedic surgeons.

Medical Malpractice: Myth vs. Fact

Amanda Schroeder, MD; David H. Sohn, JD, MD

The fear of medical malpractice lawsuits can have a negative impact on the delivery of health care in America. Physicians who fear being sued may avoid treating those they see as high-risk patients, which affects access to care. Or, they may engage in defensive medicine, which is the practice of ordering extra tests to avoid lawsuits.