Changes in the Medicare fee schedule, including plans to pay essentially the same amount for services whether performed in a hospital provider-based department (PBD) or in individual physician offices, were hailed as “significant wins” in a Health Policy Forum at the 2018 LUGPA annual meeting in Chicago.
The discussion took place a day after the Centers for Medicare & Medicaid Services (CMS) released its final fee schedule rule for 2019. It covered a number of key LUGPA objectives that Deepak A. Kapoor, MD, outlined ahead of the meeting for Urology Times. Dr. Kapoor is LUGPA’s health policy chairman. Read about the new payment system here.
Recent efforts by the nation’s hospital industry illustrate the difficulty of controlling expenditures in the nation’s $700 billion Medicare program. Congress included in the Bipartisan Budget Act of 2015 (BBA), a clear, bipartisan message that, to the extent similar services can be safely provided in multiple settings, it is not prudent for Medicare to pay more in one setting compared to another. To read more, click here.
Men with prostate cancer often survive 15 years or longer after learning they have the disease, but prostate cancer remains one of the five most common cancers and the second most frequent cause of cancer-related death among men. “This is an exciting time to be in the field of urology,” says Deepak A. Kapoor, MD. “We have a far more robust armamentarium of surgical and medical techniques. We can offer the possibility to extend survival far beyond the 18 to 24 months the patients could historically expect.”
Read more about the newer advanced prostate cancer treatment options that are offering hope, by clicking here.
“Just how value-based care will replace fee for service and what that will mean to urologists isn’t so clear,” says Deepak A. Kapoor, MD. Big health care—the system that existed before the Medicare Access and CHIP Reauthorization Act (MACRA)—is unsustainable, according to Dr. Kapoor.
To read more about value-based care, click here.
Organic condom manufacturers claim their condoms are gluten-free. But, um, since when do condoms have gluten to begin with?
If you were concerned that your condoms may contain gluten, Deepak A. Kapoor, MD sets the record straight. Read what he says here.
The Us Preventive Services Task Force, an independent panel of experts that makes recommendations to the American public about preventive services updated their previous prostates cancer screening guidelines published in 2012. In 2012, they recommended against routine screening due to the risks involved in additional testing and treatment. Their new position recommends that men between the ages of 55 and 69, particularly those at high-risk for prostate cancer, talk to their physicians about prostate cancer screening. Read the story here.
On April 25th, Dr. Riccardo Ricciardi, Jr. (AUCNY-Bayside) was designated a Urolift Center of Excellence. See video from the ceremony here.
Dr. Ricciardi has been designated a Urolift® Center of Excellence. The designation recognizes that Dr. Ricciardi has achieved a high level of training and experience with the UroLift System and demonstrated a commitment to exemplary care for men suffering from symptoms associated with benign prostatic hyperplasia or BPH. To learn more, click here.
In July 2017, the Large Urology Group Practice Association (LUGPA) submitted a proposal to PTAC. The “LUGPA APM for Initial Therapy of Newly Diagnosed Patients with Organ-Confined Prostate Cancer” proposed incentivizing urologists to choose “active surveillance” as a method for treating certain cancer patients when “clinically appropriate.”
In December 2017, PTAC voted not to recommend the LUGPA APM
In other words, doctors shouldn’t be paid for doing what they should, the committee seemed to argue. LUGPA President Deepak Kapoor, MD, said he was frustrated that even though PTAC agreed that the LUGPA model met many of the high-priority criteria, they remained “philosophically” opposed to the model. Click here to read about the frustrations that some physician group practices are expressing.
Dr. Elliot Fagelman of Stony Point, is the newest urologist to join Advanced Urology Centers of New York’s (AUCNY) Rockland County office in West Nyack. Dr. Fagelman, a board-certified physician, has extensive experience treating patients with all types of urologic issues. To learn more about Dr. Fagelman, please click here.
A urologist built an APM because the specialty of urology was left wanting when it comes to APM options. Deepak A. Kapoor, MD decided the best way to speed urology’s pivot to value-based care was to create an APM from scratch. To learn about this model, click here.
New legislation to modify the Stark antitrust law to remove barriers to independent physicians has been introduced. Deepak A. Kapoor, MD told Urology Times that the “30-year-old Stark Law self-referral prohibitions effectively block coordination of care by physicians. Stark was designed for fee-for-service, not value based care.” To read the article, click here.
Legislation would authorize CMS to pay for backup DNA tests
Deepak A. Kapoor, MD, chairman and CEO, Integrated Medical Professionals, Melville, NY, told the Energy and Commerce Committee that a 2015 study found that misdiagnoses based on needle biopsies occurred in 2.5% of cases and would largely be eliminated if the backup DNA test became standard practice (J Urol 2015; 193:1170-7). The study concluded that at least 1.28% of those patients were actually cancer free.
Dr. Kapoor is health policy chair at LUGPA, which along with the AUA, the Men’s Health Network, the Prostate Health Education Network, and several other related groups have endorsed the legislation. Read about the bill and how it benefits patients here.
Did you watch Dr. Deepak A. Kapoor and Dr. Kathleen Latino defending the LUGPA APM proposal to the full PTAC committee? If you missed it, click here to watch.
Dr. Alexander Epelbaum of Dix Hills, a urologist at Advanced Urology Centers of New York in Smithtown, has been appointed president of the medical staff at St. Catherine of Siena Medical Center in Smithtown. See the Newsday article here.
More than 1 million prostate biopsies are performed in the U.S. each year. Provenance errors (i.e. switching and contamination) in prostate cancer diagnosis occurs at a rate of 1.28%. Deepak A. Kapoor, MD and colleagues feel that the DNA test ensures that a prostate cancer diagnosis is given to the correct person. The DNA test “definitely rules out” these errors, said Dr. Kapoor. To read more about the value of DNA tests, click here. click here.
A newly proposed urology-specific alternative payment model (APM) could save up to 37% on costs of care, partly by giving physicians incentives to pursue active surveillance (AS) rather than active intervention (AI), according to the Large Urology Group Practice Association (LUGPA). To read about the model, click here.
Carl A. Olsson, MD and colleagues have been researching gender differences in osteoporosis and fertility, as well as issues of the genitourinary tract (which includes the reproductive organs and the urinary system) during prolonged missions in space. WebMD featured this fascinating interview. Click here to read the results of the study.
Force (USPSTF) were outlined by LUGPA Health Policy Chair Deepak A. Kapoor, MD, during a health policy briefing at the LUGPA annual meeting in Chicago.
Dr. Kapoor outlined LUGPA’s efforts to influence the final rules involving the Quality Payment Program established by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), the Medicare physician fee schedule for 2018, and the Hospital Outpatient Prospective Payment System and Ambulatory Surgery Center Payment System.
To read more about the LUGPA Health reform, please click here.
In recognition of the efforts in the fight against prostate cancer, Queens Borough President Melinda Katz presented Riccardo Ricciardi, MD of AUCNY Bayside with a prostate cancer proclamation and declared October 19th prostate cancer awareness day in Queens.