Ep. 205 Update on Reimbursement Cuts for the OBL/ASC with Dr. Jim Melton and Dr. Blake Parsons

Ep. 205 Update on Reimbursement Cuts for the OBL/ASC with Dr. Jim Melton and Dr. Blake Parsons

In this episode Vascular Surgeon Jim Melton and Interventional Radiologist Blake Parsons give us the lay of the land on recent reimbursement cuts in the OBL/ASC space, including peripheral artery disease treatments and embolization procedures, as well as projections of what to expect in the next few years. --- CHECK OUT OUR SPONSOR Boston Scientific Eluvia Drug-Eluting Stent https://www.bostonscientific.com/en-US/medical-specialties/vascular-surgery/drug-eluting-therapies/eluvia/eluvia-clinical-trials.html?utm_source=oth_site&utm_medium=native&utm_campaign=pi-at-us-de_portfolio-hci&utm_content=n-backtable-n-backtable_site_eluvia_1&cid=n10008043 --- SHOW NOTES In this episode, host Dr. Aaron Fritts interviews interventional radiologist Dr. Blake Parsons and vascular surgeon Dr. Jim Melton about navigating recent Medicaid reimbursement cuts in their hybrid Office Based Lab (OBL) and Ambulatory Surgery Center (ASC), CardioVascular Health Clinic. This episode largely follows a question and answer format, where our guests respond to previously-submitted audience questions. The guests start by outlining recent vascular surgery and interventional radiology reimbursement cuts from 2022, as well as sharing information on future cuts through 2026. Most cuts are PAD-focused, but they also include pain management procedures like kyphoplasty. Dr. Parsons advises IRs to think about diversifying their practices to encompass procedures outside of PAD. He summarizes the average profits generated in various types of IR cases. He also predicts that there will be more reimbursement cuts on embolization cases, as prostate and geniculate embolizations become more popular. To protect profit margins by means of cost reduction, the doctors negotiate with vendor pricing and try to leverage disposables against capital. Dr. Melton describes the current political landscape and physician advocacy efforts. While industry has started to position themselves to help advocate for OBLs and ASCs, Dr. Melton believes that industry and physicians should be more politically active. He encourages physicians to get involved with their medical societies and reach out to local representatives and senators in order to highlight the benefits of patient care in an OBL/ASC setting– faster recovery, lower risk of infection, and overall lower cost for the healthcare system. --- RESOURCES CardioVascular Health Clinic: https://cvhealthclinic.com/ SIRPAC: https://www.sirweb.org/advocacy/sirpac/ OEIS: https://oeisociety.com/

Episoder(606)

Ep. 85 Genicular Artery Embolization for OA with Dr. Jafar Golzarian

Ep. 85 Genicular Artery Embolization for OA with Dr. Jafar Golzarian

In this episode, Dr. Jafar Golzarian joins Dr. Michael Barraza to discuss genicular artery embolization for osteoarthritis. Dr. Golzarian describes how he worked and collaborated with orthopedic surgeons to offer this procedure for his patients. He also speaks about some potential underlying causes and aggravating factors for osteoarthritis. Dr. Golzarian provides useful tips on taking an academic approach to setting up trials and what makes his trials different from previous studies on genicular artery embolization. We discuss why patients with osteoarthritis can be a challenge for family practitioners and how collaboration with IR can benefit these patients. We go into the differences in the procedure for hemarthrosis and osteoarthritis. We review some ways to find the best angle to identify an arterial origin for embolization, and we discuss some of the challenges in the embolization procedure and how to adapt to different types of patients.

28 Sep 202035min

Ep. 84 An Interview with Dr. Ernie Ring- WAIS Series

Ep. 84 An Interview with Dr. Ernie Ring- WAIS Series

Ep. 84 An Interview with Dr. Ernie Ring- WAIS Series by BackTable

22 Sep 202047min

Ep. 83 An Interview with Dr. David Kumpe- WAIS Series

Ep. 83 An Interview with Dr. David Kumpe- WAIS Series

An Interview with Dr. David Kumpe- WAIS Series by BackTable

21 Sep 20201h 7min

Ep. 82 An Interview with Dr. Dan Sze- WAIS Series

Ep. 82 An Interview with Dr. Dan Sze- WAIS Series

Ep. 82 An Interview with Dr. Dan Sze- WAIS Series by BackTable

20 Sep 202037min

Ep. 81 Intra-Arterial Chemotherapy for Retinoblastoma with Dr. Eric Monroe

Ep. 81 Intra-Arterial Chemotherapy for Retinoblastoma with Dr. Eric Monroe

In this episode, Dr. Eric Monroe joins Dr. Christopher Beck to discuss using intra-arterial chemotherapy (IAC) as a treatment for retinoblastoma. Dr. Monroe touches on how he has been using telemedicine during this time and the process of considering a patient for IAC. We go over the details of the intra-arterial chemotherapy procedure and we mention some challenges that may arise in dealing with equipment for pediatric patients, specifically how to have a successful procedure while maintaining a low radiation dose. Dr. Monroe speaks about post procedural care including follow-up intervals and what those visits entail. We discuss some of the common complications that can occur during intra-arterial chemotherapy. Dr. Monroe gives some advice about the mental preparation and learning curve that comes with developing skills for IAC. Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/RRlyP6 RESOURCES MENTIONED: A Review of the Literature for Intra-Arterial Chemotherapy used to Treat Retinoblastoma https://pubmed.ncbi.nlm.nih.gov/26886915/ This is the article mentioned by Dr. Monroe which gives an overview of retinoblastoma.

8 Sep 202039min

Ep. 80 Making Ethics Matter with Dr. Eric Keller

Ep. 80 Making Ethics Matter with Dr. Eric Keller

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/gpvwSB In this episode, Dr. Eric Keller joins Dr. Christopher Beck to discuss medical ethics within IR. He speaks about using a bottom-up approach of applied ethics, and we examine why a combination of casuistry and virtue ethics may be helpful rather than principlism. We dig deeper into medical futility and the challenge of prospectively determining if a procedure is futile. Dr. Keller describes how to design a study that can explore medical ethics as well as methods of collecting and presenting data in an ethical way. We discuss advanced care planning, managing bias, and the role that unbounded ethicality plays in research. We talk through some benefits and drawbacks of ethics boards as well as how using decision support aides may improve informed consent and allow patients to become advocates for themselves. RESOURCES MENTIONED: Journal of the American Geriatrics Society https://onlinelibrary.wiley.com/action/doSearch?AllField=futility&SeriesKey=15325415 This website presents all the papers in the journal that are related to futility. Journal of the American Geriatrics Society (Medical Futility: Where Do We Go from Here?) https://onlinelibrary.wiley.com/doi/epdf/10.1111/j.1532-5415.1994.tb06570.x This article discusses various perspectives on medical futility. Decision Aids to Help People who are Facing Health Treatment of Screening Decisions https://www.cochrane.org/CD001431/COMMUN_decision-aids-help-people-who-are-facing-health-treatment-or-screening-decisions This article evaluates the effects of decision aids on health outcomes. Prevalence of Unprofessional Social Media Content Among Young Vascular Surgeons https://pubmed.ncbi.nlm.nih.gov/31882313/ American Geriatrics Society Feeding Tubes in Advanced Dementia Position Statements https://onlinelibrary.wiley.com/doi/full/10.1111/jgs.12924 This article discusses feeding tubes and how to handle feeding for patients with advanced dementia. The Impact of Advance Care Planning on End of Life Care in Elderly Patients https://www.bmj.com/content/bmj/340/bmj.c1345.full.pdf This article describes a randomized controlled trial that examines advanced care planning. Does Facilitated Advance Care Planning Reduce the Costs of Care Near the End of Life? https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4838173/ This paper discusses the ethical conflicts in advanced care planning. Responding to Requests for Potentially Inappropriate Treatments in Intensive Care Units https://www.atsjournals.org/doi/full/10.1164/rccm.201505-0924ST This article describes how to handle treatment disagreements in the ICU. Research Ethics in IR: The Intersection Between Care and Progress https://pubmed.ncbi.nlm.nih.gov/32359529/ This paper mentions the ethical issues in collecting and presenting data. It also discusses the role IR plays in conflict of interest and bias. Understanding Bias: A Look at Conflicts of Interest in IR https://www.researchgate.net/publication/332750177_Understanding_Bias_A_Look_at_Conflicts_of_Interest_in_IR This article examines conflicts of interest and how they affect the field of IR. Reflect and Remember: The Ethics of Complications in Interventional Radiology https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6531013/ This paper discusses the ethics behind the relationship between IR and complications. Informed Consent: Beating a Dead Horse or an Opportunity for Quality Improvement? https://www.researchgate.net/publication/338303598_Informed_Consent_Beating_a_Dead_Horse_or_an_Opportunity_for_Quality_Improvement This paper examines the ethical implications of informed consent and its complexities. Reconsidering Requests - Futility in IR https://www.jvir.org/article/S1051-0443(19)30069-7/fulltext This article discusses the ethics in challenging healthcare situations.

4 Sep 202056min

Ep. 79 Building a Deep Venous Program with Dr. Jeffrey Chick

Ep. 79 Building a Deep Venous Program with Dr. Jeffrey Chick

Interventional Radiologist Dr. Jeffrey Chick tells us about his deep venous practice at UW Medicine including tips on growing a collaborative, multidisciplinary venous program.

31 Aug 202035min

Ep. 78 Is Radioembolization a Future Option for Prostate Cancer Therapy? with Dr. Sam Mouli

Ep. 78 Is Radioembolization a Future Option for Prostate Cancer Therapy? with Dr. Sam Mouli

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/xI8Csf  Interventional Radiologists Dr. Sam Mouli from Northwestern University and Dr. Sandeep Bagla discuss new research examining Y-90 Radioembolization as a novel therapeutic option for treating prostate cancer.

24 Aug 202030min

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