November 18, 2015 | | JFAS | Contact Us

News From ACFAS

Exhibit Hall: Meet, Greet and Eat
When you visit the ACFAS 2016 Exhibit Hall in Austin, know "you’ll be in the spot, stylin’, wilin’ and livin’ it up!" Every day promises something fresh and exciting to amplify your conference experience, including:
  • Brand-new vendors and interactive product demos
  • One-of-a-kind HUB sessions on telemedicine, negotiating contracts with insurance providers, hiring PAs and NPs and more
  • Third annual ACFAS Job Fair with resources for employers and jobseekers alike
  • Free headshots taken by a professional photographer (includes touchup from a makeup artist)
  • Award-winning posters featuring the latest groundbreaking research
Don’t believe the ACFAS 2016 Exhibit Hall will have even more to see and do than last year's? Just watch!
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Don’t Be Roomless in Austin…
Protect yourself from hotel poachers and book your room for ACFAS 2016 with the College’s official housing partner, onPeak, LLC.

Reserve your room safely with onPeak and be guaranteed the lowest hotel rates available through our exclusive link, If any organization other than onPeak contacts you, don’t give them your credit card information or a cash deposit.
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Final Call for 2016 Volunteer Leaders
Don’t miss your chance to help shape the future of ACFAS and the profession by volunteering to serve on one of 11 College committees for 2016–2017. If you would like to volunteer, visit All applications must be received by this Friday, Nov. 20.
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Foot and Ankle Surgery

History-Dependent Changes in the Recovery Process of the Middle Latency Cutaneous Reflex Gain After Ankle Sprain Injury
A new study looked to determine the time-varying history of neurophysiological changes after ankle sprains by analyzing the recovery time for middle latency cutaneous reflexes (MLRs) in relation to the number of sprain recurrences. In 23 patients with ankle sprain, the gain of MLRs first increased four weeks after injury. MLRs returned to almost baseline levels after three months in patients with first-time sprains. In patients with recurrent sprains, MLR gain persisted even after three months. The findings indicated that history of ankle sprains had a significant effect on the recovery process of MLR gains.

From the article of the same title
European Journal of Applied Physiology (11/15) Futatsubashi, Genki; Sasada, Syusaku; Ohtsuka, Hiroyuki; et al.
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Most Patients Return to Activity Without Pain After Surgery for Tarsal Coalitions
A recent study found that the majority of patients who underwent surgical excision of tarsal coalitions at age 18 or younger indicated no pain upon return to normal activity. The study looked at 20 patients with talocalcaneal (TC) coalitions and 43 with calcaneonavicular (CN) coalitions. Overall, 73 percent reported their activity levels were not affected, noting American Orthopaedic Foot and Ankle Society scores of 93.9 and a University of California at Los Angeles activity scale score of 8.9. Even though 27 percent of patients reported lower outcomes, researchers determined that the differences were not significant between patients who underwent CN versus TC coalitions.

From the article of the same title
Healio (11/10/2015)
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Practice Management

Five Steps to Improve the Patient Experience
Strengthening the relationship between providers and patients can lead to lower costs and better overall patient care. The Affordable Care Act's emphasis on value-based and patient-centered care makes this even more important. Here are five steps you can take to ensure the best patient experience:
  • Make your practice look and feel engaging. Making a good first impression is the most important part of the visit. Craft a well-designed website that is easy to navigate, and be sure your office is clean, inviting and well lit, a place where patients know they will feel cared for.
  • Honor patients with respect and attention. Patients deserve your attention from the start of an appointment all the way to the end. Train your staff in good customer service practices. Be sure your entire office is aware of the customer service mission.
  • Improve communication at every step of the patient visit. Answer the phone quickly and with enthusiasm, introduce yourself, smile and never say no to a patient. Listen to cues and determine how they feel in your office. Are they worried? Confident? Address them according to how they present themselves.
  • Make ease-of-access a top priority. Use an efficient appointment scheduling system and make sure you have enough appointments available. Start on time and end on time, so that patients are not kept waiting.
  • Commit to timeliness. Answer the phone. Do not put patients on hold for more than 30 seconds. Diligently return calls and emails, and be sure your staff does the same.
From the article of the same title
Diagnostic Imaging (11/11/15) Capko, Judy
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Healthcare Employees Often Complacent About Security
Non-technical healthcare employees do not take data security seriously enough, according to a new survey from Trustwave. While 91 percent believed cyber criminals are targeting more health organizations than ever, only 10 percent of their IT budgets are tailored toward data protection. “There’s a typical ‘it can’t happen to me’ phenomenon,” said Steve Kelley, senior vice president of product and corporate at Trustwave. “It has either already happened to you, or will happen to you — or you’re not just aware of it yet." Only 14 percent of non-technical employees and 23 percent of technical employees thought their organization had experienced a breach, which is not surprising considering that only 38 percent get security training at least twice a year. Six percent receive no training at all. “There’s a gap between how sensitive this information is, and how prepared they actually are,” said Kelley.

From the article of the same title
Health IT Outcomes (11/13/2015) Kern, Christine
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ICD-10 Transition: Monitor to Catch Problems Early
One of the most important parts of keeping up with ICD-10 changes is staying on top of denied claims. According to Deborah Grider, CPC, taking care of denials early can prevent difficulties down the road. “You need to work those denials quickly and sort them by type,” she said. “If you notice that you are getting more denials for invalid or unspecified coding or are not meeting medical necessity, you need to sort and track them to get an idea of who is denying what.” Here are more of Grider's suggestions for staying up to date with ICD-10:
  • Review your ICD-10 codes. You should regularly run reports on the codes you bill most frequently. Those denials can have the biggest effect on your revenue.
  • Keep on top of accounts receivable. Many practices review accounts receivable on a monthly basis. Instead, try reviewing them weekly. It is important to address denials quickly to avoid costly errors.
  • Do not rely on the grace period. Medicare has announced it will not reject claims solely due to unspecified coding within the first year of ICD-10. Do not wait until that grace period is over to review your documentation. Use the time to work out a strategy and address minor glitches.
  • Create a cheat sheet. Make a list of the most common diagnoses and their ICD-10 codes. This will save you a lot of time in the near future.
  • Schedule audits. Wait about a year until everything is settled and then start auditing your coding regularly. Schedule an audit once every three months.
From the article of the same title
Physicians Practice (11/11/15) Colwell, Janet
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Three Ways to Deliver Feedback, Empower Your Team
Every medical practice depends on its staff to remain functional and efficient, and it is important that you create an environment where your staff feels welcomed and empowered. Here are three ways to lead your staff and keep them engaged with mindful communication:
  • Be curious. Do not assume your employees perceive their behavior the same way you do. Emphasize that you want to hear their opinions and listen closely before jumping to conclusions.
  • Be empathetic. It is often difficult hearing feedback from a boss, so use an anecdotal approach. Tell a story about a similar experience you had and how you applied those lessons to become a practice leader.
  • Be vulnerable. It is never easy to exude vulnerability, especially when you are trying to lead. Being vulnerable can open doors with your employees and can create an open, safe environment that liberates the organization of tension.
From the article of the same title
Fierce Practice Management (11/10/15) Cryts, Aine
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Health Policy and Reimbursement

CMS Withdraws Controversial Limits on Prosthetics Coverage
The Centers for Medicare and Medicaid Services (CMS) have reversed a recent coverage decision that advocates say would have blocked patient access to artificial limbs. In July, CMS overhauled Medicare reimbursement for lower-limb prosthetics, and advocates worried that private payers and the Veterans Health Administration would follow suit, potentially affecting as many as 1.7 million people. Within the proposal was a section that stated that amputees who use a cane or crutches instead of putting on their prostheses at any point are defined as having a prosthesis that is not medically necessary. CMS then decided to table the proposal, issuing a statement: “Both CMS and its contractors have heard your concerns about access to prostheses for Medicare beneficiaries,” the agency said in a Nov. 2 notice on its site. “The Durable Medical Equipment Medicare Administrative Contractors will not finalize the draft (coverage determination) at this time." The agency will work with industry experts to craft a new policy.

From the article of the same title
Modern Healthcare (11/09/15) Dickson, Virgil
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Doctors More Optimistic About Making Profit
U.S. physicians expect their profits to level out next year, rather than decline, according to a new report. About 35 percent of physicians said they expect profits to stay the same, compared with 30 percent last year. Around 31 percent expect profits to decline, which is less than the 39 percent who responded that way last year. In addition, 24 percent expect profits to rise, a five percent increase over 2014. The expansion of codes under ICD-10 has affected many practices, but the outlook for revenue looks better than it has in several years. The survey also found that more doctors expect to keep their practice instead of selling or merging.

From the article of the same title
Chicago Tribune (11/10/15) Russell, John
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How a Cadillac Tax Repeal Affects Revenue Cycle Management
The Affordable Care Act's (ACA) controversial Cadillac Tax is again up for debate, and it could be repealed soon. The tax, a 40 percent excise tax beginning in 2018, could affect one-third of employers in terms of ACA compliance. It is still unclear how exactly the tax will change revenue cycle management. Some believe it will be bad for revenue. Rep. Joe Courtney (D-CT) believes it will negatively affect the health plans of working families, retirees and Baby Boomers. According to Courtney, if the tax is supposed to reduce unnecessary spending, then it will also reduce critical spending, which could lead to poorer outcomes for patients. Still, some believe the tax will be positive for revenue. In a recent New York Times piece, Ezekiel J. Emanuel and Bob Kocher wrote that the tax will raise $91 billion and decrease out-of-pocket costs, costs that need "immediate addressing." Some estimates indicate that healthcare spending could soon exceed $10,000 per person if high-deductibles complicate point-of-service collection efforts.

From the article of the same title
RevCycle Intelligence (11/09/15) DiChiara, Jacqueline
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Medicine, Drugs and Devices

FDA Warns of Cyber Threats to Networked Medical Devices
Networked medical devices “introduce new risks related to potential cybersecurity threats," according to Suzanne Schwartz, director of emergency preparedness/operations and medical countermeasures for the U.S. Food and Drug Administration (FDA) Center for Devices and Radiological Health. At the recent HIMSS Connected Health Conference in Washington, D.C., Schwartz notified the audience that FDA views medical device cybersecurity as a top priority and that providers need to understand their devices. While medical device manufacturers must provide Manufacturer Disclosure Statement for Medical Device Security forms, Schwartz said that these guidelines need to be updated so that devices are secure for the duration of their life cycle. She referenced a July FDA alert that said a computerized infusion pump had serious cybersecurity vulnerabilities and a September FBI investigation that warned of the cybersecurity risks associated with certain devices. Now that these security flaws are continually coming to light, the U.S. Department of Health and Human Services Office of the Inspector General announced it will conduct an audit looking at whether FDA sufficiently protects health information.

From the article of the same title
Health Data Management (11/11/15) Slabodkin, Greg
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New FES Device Could Improve Gait in Patients with Foot Drop
A new system called the WalkAide can improve gait and assist patients with foot drop, according to new research. The device is a battery-operated neuroprosthesis that uses electrodes and calculates dorsiflexion of the ankle during gait cycle to improve limb clearance during swing phase. It was successful in trials with patients who had spastic cerebral palsy, 95 percent of whom preferred it over second options. In comparison to standard braces, the WalkAide improves dorsiflexion and plantarflexion, and it increases positive effects over time. Ankle motion improved both with and without the device at follow-up. In addition, a second study found that the device increased cross-sectional area and muscle thickness.

From the article of the same title
Healio (11/11/2015) Carter, Shawn M.
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Olokizumab Shows Potential for Tough-to-Treat Rheumatoid Arthritis
Researchers have determined that using olokizumab can successfully treat active moderate-to-severe rheumatoid arthritis. Olokizumab is an investigational humanized monoclonal antibody and can be used when disease-modifying anti-rheumatic drugs fail. Dr. Mark C. Genovese, co-chief of the Division of Immunology and Rheumatology at Stanford University Medical Center in Palo Alto, said that the results were promising. "The data show that olokizumab was well tolerated, with a safety profile expected for this class of agent, and reductions in disease activity were sustained to week 48," he said. The results also indicate that olokizumab can be continually developed, and a phase 3 program is currently in the planning stages.

From the article of the same title
Medical News Today (11/11/15) Stein, Jill
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This Week @ ACFAS
Content Reviewers

Mark A. Birmingham, DPM, AACFAS

Robert M. Joseph, DPM, PhD, FACFAS

Daniel C. Jupiter, PhD

Jakob C. Thorud, DPM, MS, AACFAS

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This Week @ ACFAS is a weekly executive summary of noteworthy articles distributed to ACFAS members. Portions of This Week are derived from a wide variety of news sources. Unless specifically stated otherwise, the content does not necessarily reflect the views of ACFAS and does not imply endorsement of any view, product or service by ACFAS.

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