Ep. 287 OBL/ASC Reimbursement Update Jan 2023 with Dr. Jim Melton and Dr. Blake Parson

Ep. 287 OBL/ASC Reimbursement Update Jan 2023 with Dr. Jim Melton and Dr. Blake Parson

In this episode, host Dr. Aaron Fritts interviews Dr. Jim Melton, vascular surgeon, and Dr. Blake Parsons, interventional radiologist, about progress in the OBL and ASC space, including reimbursement updates, partnering with a private equity firm, and value based care. --- CHECK OUT OUR SPONSOR Surmodics Pounce Thrombectomy https://pouncesystem.com/ --- SHOW NOTES We begin by discussing new developments in Dr. Melton’s and Dr. Parson’s practice. Over the past year, they have partnered with a private equity firm, Assured Healthcare Partners to create Heart and Vascular Partners (HVP). They now cover Oklahoma City, Colorado Springs, Denver, Pueblo, and parts of Illinois and Indiana. They employ mostly hospital based physicians’ ready to start their own office based lab (OBL) or ambulatory surgery center (ASC). The physicians under HVP are cardiologists, vascular surgeons, and interventional radiologists. The two discuss the advantages of aligning with a private equity firm. For them, it provided the scale and capability to provide value-based care when it becomes widely adopted. Additionally, the payer has a much lower cost for the service in the outpatient space versus the hospital. All the physicians in HVP maintain local control over their practices, which was one of their main goals when they decided to partner with a firm. Next, we cover reimbursement cuts and the trends in OBLs and ASCs. On the arterial side of business, they are seeing that OBLs are down 10-15% in reimbursement rates, whereas ASCs are up 3-30%. For iliac interventions in the ASC, they have seen a 30-50% increase in balloon angioplasty and stenting, and up to a 60% increase for Shockwave. On the embolization side, arterial and venous reimbursement has dropped in the OBL by 7-8% and increased in the ASC by 3-30%. Alternatively, the CPT code for embolization for end organ ischemia (UFE, PAE) is still well reimbursed in the OBL. They caution listeners on genicular artery embolization and cryoneurolysis due to the risk of not getting it reimbursed and having to pay money back. --- RESOURCES Heart and Vascular Partners: https://heartandvascularpartners.com

Avsnitt(610)

Ep. 50 Practicing IR in India with Dr. Deepa Shree

Ep. 50 Practicing IR in India with Dr. Deepa Shree

Dr. Deepa Shree tells us about the challenges she faced building her IR practice in Chennai, and how she is spreading awareness of the specialty and training new IRs to help serve the need throughout India.

13 Okt 201948min

Ep. 49 Collaboration in the Hybrid OR with Dr. Racadio and Dr. von Allmen

Ep. 49 Collaboration in the Hybrid OR with Dr. Racadio and Dr. von Allmen

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/Ucy8jI Director of IR Innovation Dr. John Racadio and Pediatric Surgeon-in-Chief Dr. Daniel von Allmen of Cincinnati Children’s Hospital discuss their experiences in the Hybrid OR, how they built it, and how cross-specialty collaboration with pulmonary, urology, and orthopedic surgeons has greatly improved patient care.

30 Sep 201929min

Ep. 48 IR and ENT Treatment of Epistaxis with Dr. Ashley Agan and Dr. Sabeen Dhand

Ep. 48 IR and ENT Treatment of Epistaxis with Dr. Ashley Agan and Dr. Sabeen Dhand

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/xQPc7h In this episode, Dr. Ashley Agan and Dr. Sabeen Dhand join Dr. Gopi Shah to discuss IR and ENT treatment of epistaxis. We cover the differences in how epistaxis presents for ENT and IR as well as how epistaxis presents in children and older patients. Dr. Agan tells us about the types of nosebleeds that are common and the general treatment algorithm she follows. We discuss nasal packing and decongestant sprays for treatment and how to know when to take the patient to the OR. Dr. Agan talks about isolating the bleeding spot, how to use a foley for posterior nosebleeds, and SPA litigation. We discuss why ENT might consult IR for an embolization. Dr. Dhand tells us about the contraindications for embolization and the procedure for treating the epistaxis. We review the materials that should be used and why it is important to look out for artery connections and pseudoaneurysms. We discuss the pearls and pitfalls of ENT and IR treatment of epistaxis and how to avoid the risk of stroke.

30 Aug 201933min

Ep. 47 BRTO vs. PARTO and other Techniques with Dr. Luke Wilkins

Ep. 47 BRTO vs. PARTO and other Techniques with Dr. Luke Wilkins

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/ZvpYnL Special Guest Dr. Luke Wilkins of University of Virginia VIR discusses BRTO and PARTO techniques for treatment of gastric variceal bleeding.

18 Aug 201941min

Ep. 46 Collaboration not Competition between IR and IC with Dr. Achal Sahai and Dr. Chris Beck

Ep. 46 Collaboration not Competition between IR and IC with Dr. Achal Sahai and Dr. Chris Beck

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/bobcIg Interventional Cardiologist (IC) Dr. Achal Sahai and Interventional Radiologist (IR) Dr. Christopher Beck discuss ways these two specialties collaborate on complex cases, share endovascular techniques, and avoid the "turf war" trap.

31 Juli 201945min

Ep. 45 Coping with Complications with Dr. Maureen Kohi and Dr. Sandeep Bagla

Ep. 45 Coping with Complications with Dr. Maureen Kohi and Dr. Sandeep Bagla

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/uVVOw3 Dr. Maureen Kohi from UCSF Medical Center and Dr. Sandeep Bagla from Vascular Institute of Virginia discuss the challenges of dealing with procedural complications, and the importance of talking with colleagues and mentors in effective coping.

1 Juli 201959min

Ep. 44 TIPS Procedure Techniques: East to West Coast with Dr. Peder Horner and Dr. Peter Bream

Ep. 44 TIPS Procedure Techniques: East to West Coast with Dr. Peder Horner and Dr. Peter Bream

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/2WK9kp East Coast "McBreamy" and "Western Peder" discuss their Colapinto vs. Uchida needle preference, advantages of the ICE catheter, and other great pearls and pitfalls for the TIPS Procedure. Special thanks to our sponsor RADPAD® Radiation Protection. Protect yourself and your patients during those lengthy TIPS cases.

16 Juni 20191h

Ep. 43 Managing Urosepsis with Dr. Caire and Dr. Bennett

Ep. 43 Managing Urosepsis with Dr. Caire and Dr. Bennett

Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/rn9T7J Urologist Dr. Arthur Caire and IR Dr. Shelby Bennett return to the BackTable Podcast to discuss their approaches to urosepsis, stent vs. nephrostomy for a variety of presentations, and the middle-of-the-night patient.

2 Juni 201934min

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