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  • 04/25/2019 2:33 PM | Anonymous

    APWCA's weekly Wound Care Report which has the latest developments in wound care news publication featuring the following articles:

    • Researchers develop wearable biosensors that mimic skin's properties
    • 4 ways to integrate digital health into the wound center today
    • Researchers pinpoint microbial strains that delay healing in diabetic foot ulcers
    • Negative-pressure wound therapy for managing complicated wounds at extracorporeal membrane oxygenation sites
    • 5 surprising ways to create a more patient-friendly vibe at your practice
    • Chronic wounds are the massive global health problem no one's talking about, doctor warns
    • Guidelines for safe negative-pressure would therapy

    April 24th, 2019  |  Archives

  • 04/22/2019 7:00 AM | Anonymous

    Keep up to date with the latest developments in wound care news through APWCA's weekly email publication Wound Care Report.

    April 17th, 2019  |  Archives

  • 03/15/2019 4:41 PM | Anonymous

    NEW THIS YEAR! Special APWCA discounted rate of $299 (Enter code: APWCA-2019) to attend the 20th Anniversary NCVH 2019 Annual Conference, which now includes a day-long educational track focused on the interdisciplinary integrated team approach to wound care - Save hundreds of dollars!

    Register Here!

    APWCA will be presenting a full day didactic session on May 31st! See schedule of the day below:

    10:00 - 11:20AM NCVH/APWCA Session IV: Reconstruction of Complex Tissue Defects in the Lower Extremities
    10:00 - 10:10AM The Importance and Goals of Wound Healing in Limb Preservations, Charles Andersen, MD
    10:10 - 10:20AM When to get a Vascular Consult and the Limitation of Non-Invasive Vascular Studies, Craig Walker, MD
    10:20 - 10:30AM Identifying the Etiology of the Wound, Charles Andersen, MD
    10:30 - 10:40AM Debridement of the Complex Wound: Extent, Tools and Frequency Stephanie Wu, DPM
    10:40 - 10:50AM Controlling the Bacteria in the Wound: Topical vs. Systemic Treatment, Charles Southerland, DPM
    10:50 - 11:00AM Venous Ablation for the Venous Leg Ulcers: Indications and Timing, Robert Coronado, MD
    11:00 - 11:10AM THat is the Role of Cellular and or Tissue Based Products in Dermal Reconstruction: Evidence Based Medicine, Steven Kavros, DPM

    11:20 - 1:30PM Lunch/Lunch Symposia/Exhibits

    1:30 - 3:00PM [Podiatry and Wound Care] Session V: Reconstruction of Complex Tissue Defects in the Lower Extremities
    1:30 - 1:40PM Hyperbaric Oxygen Therapy: What is the Evidence? Jeffrey Niezgoda, MD
    1:40 - 1:50PM Vascular Imaging: Evidence to Improve Outcomes, Jeffrey Ross, DPM, MD
    1:50 - 2:00PM When to Consider Flaps vs. Split Thickness Skin Grafts, Charles Southerland, DPM
    2:00 - 2:10PM Taking the Mystery Out of Offloading: It is more than a Simple Insert, Steven Kavros, DPM
    2:10 - 2:20PM Compression Therapy for Chronic Venous Insufficiency: Compression Wraps vs. Gradient Support Hose, Cheryl Bongiovanni, PhD
    2:20 - 2:30PM Topical Oxygen: Hocus or Evidence Based, Stephanie Wu, DPM
    2:30 - 2:40PM What is Feasible for Complex Would Healing in the Changing Economic and Reimbursement Environment, Steven Kavros, DPM
    2:40 - 2:50PM Questions and Answers/Panel Discussion
    2:50 - 3:00PM Closing Remarks, Frank Tursi, DPM 

    3:00PM Adjourn

  • 06/12/2018 9:45 AM | Deleted user

    Recent research demonstrates the effectiveness of various foam dressings for pressure redistribution. Jeffrey Niezgoda, MD (APWCA Vice-President) recently published his findings in a poster presentation (SAWC 2018).  His results demonstrated that all foams are not equivalent in the ability to provide pressure relief in patients at risk for developing pressure ulcers.  OxyBand Rescue out performed all other foam dressings currently on the market, providing superior reduction in average pressures and peak pressures, while at the same time maximizing contact area.  The NPUAP has recently published recommendations advocating the use of foam dressings to provide pressure redistribution in an attempt to reduce the risk of pressure ulcer formation in at risk patients.  A copy of the Poster is provided.  

  • 02/23/2018 1:17 PM | Anonymous

    The Centers for Medicare and Medicaid Services (CMS) recently released an announcement seeking input from stakeholders on a new electronic clinical quality measure under development titled, “Hospital Harm – Hospital-Acquired Pressure Injury.”

    This measure assesses the proportion of hospitalized patients 18 years and older who develop a new stage 2-4 pressure ulcer, deep tissue injury, unstageable pressure ulcer, or experience worsening of any of the above during their hospitalization.

    We read the full description of the measure and provided the following feedback on behalf of APWCA membership:

      • Concern that the denominator has no exclusions; made the point all pressure ulcers are not preventable
      • Responded to one of the questions posed by the measure authors by explaining protocols may change for end-of-life or hospice patients who have comfort care-only orders
        -- Clarified this could be difficult to track because comfort care-only orders may not be captured in some EHR systems and some hospitals are still not using a fully functional EHR
        • Suggested denominator exclusions be added to this measure, including:
        -- Palliative care
        -- End-of-life care
        -- Metastatic malignancies
        -- Septic shock

        This is just one example of how APWCA advocates for our members.  To learn more about your membership and benefits visit www.apwca.org.

        If you would like to submit comments on your own, follow these instructions provided by the Alliance of Wound Care Stakeholders:

                      1. Select “Projects” at top middle on home screen
                      2. Select “View All Projects”
                      3. Select “Quality-Measures” on left-side of screen
                      4. Select “Comments on eCQMs under development” project
                      5. To enter comments, select “Create” (orange button) at the top middle of the screen
                      6. Select the type of issue from the “Issue Type” drop-down menu
                      7. In “Summary” field, type the following title: 
                          Hospital Harm – Hospital Acquired Pressure Injury
                      8. Select the measure name for comment on from the “Draft Measures” drop-down: 
                          Hospital Harm – Hospital Acquired Pressure Injury
                      9. Fill out fields labeled “Contact name,” “Contact email,” and “Contact phone”
                    10. Enter comments in the “Description ”field or upload an attachment under the “attachment” field
                    11. Select “Create” at the bottom left to submit comments
                    12. For additional comments, select “Create another” and then “Create”

      • 02/06/2018 11:28 AM | Anonymous

        Immediate Medicare Changes That May Affect You

        The Medicare Administrative Contractor (MAC) for Jurisdiction J (Tennessee, Alabama, and Georgia) is transitioning from Cahaba to PalmettoThe Part A transition went into effect January 26, 2018 and Part A providers should already be submitting claims to Palmetto GBA. Cahaba has discontinued the receipt of Part A redetermination, reopening, and ADR submissions via the InSite Web Portal. 

        Any of your Part A Redeterminations, Reopenings or ADR responses should now be sent to:

        Cahaba Medicare Part A
        Post Office Box 6168
        Indianapolis, IN 46206

        If you have been communicating with Cahaba via FAX, you may find that some of those FAX lines are no longer functioning, including some that deal with Part B. If you need to communicate Part B information to Cahaba after January 26, 2018 they ask that you use this mailing address:  

        Cahaba Medicare Part B
        Post Office Box 6169
        Indianapolis, IN  46206

        The Part B transition goes into effect February 26, 2018.  Providers should note that their Local Coverage Determinations (LCDs) will transition from Cahaba to Palmetto. A listing of Palmetto LCDs can be found here: Software vendors should update their software to send claims to:

        Part A:
        Palmetto GBA
        Attn: JJ Medicare Part A PO Box 100305
        Columbia, SC 29202-3305 

        Part B:
        Palmetto GBA
        Attn: JJ Medicare Part B PO Box 100306
        Columbia, SC 29202-3306 

        More information can be found at the Jurisdiction J Transition website:  https://www.palmettogba.com/JJTransition

      • 01/25/2018 9:52 AM | Anonymous
        President, Dr. Steven Kavros, and member, Dr. Robert Coronado have been published in the February issue of Advances in Skin and Wound Care. ‘Diagnostic and Therapeutic Ultrasound on Venous and Arterial Ulcers: A Focused Review’ can be read online now.
      • 11/06/2017 4:27 PM | Anonymous

        In August 2017, the APWCA distributed a survey to its members to collect their perceptions about change in the pressure ulcer staging system as proposed by the National Pressure Ulcer Advisory Panel (NPUAP). The proposed change was centered around the use of the term 'pressure injury' to replace 'pressure ulcer'.

        An invitation email was sent to the APWCA's 1020 members. About 190 members accessed the survey and about 150 responses were submitted. This results in a response rate of 15% and provides a Confidence Interval of ± 7%. The survey consisted of 6 items. Each item and its results are appended in this report.


        • A plurality of respondents (40%) felt that 'pressure ulcer' was the most acceptable term with 30% of respondents deeming both 'ulcer' and 'injury' to be acceptable.
        • A slight majority of respondents (58%) felt that Stage 1 and Deep Tissue Injury (DTI) should be included in the staging system despite the drawback of including lesion that occur in the absence of broken skin
        • A plurality of respondents preferred to keep the term 'stages' (43%) as opposed to 'categories' (28%) in describing the continuum of ulcerations included in the classification scheme.
        • An equal number of respondents felt that pressure ulcer (38%) or both pressure ulcer or injury (37%) were reflective of etiology.
        • A plurality of respondents (43%) felt that a change in terminology should be first addressed by entities charged with nomenclature and policy before changes are implemented. This indicates a desire for a procedural sequence to be undertaken before adopting new terminology.
        • A significant majority of respondents (70%) felt that 'injury' reflects an implication of harm even if it is unintended. This is an important finding as it reflects the fact that some respondents preferring 'injury' and those accepting of both 'ulcer' and 'injury' expressed this concern.


        Taken together, the results indicate that while a plurality of APWCA respondents would prefer to keep the term ulcer, many would be accepting of the term 'injury'. That being said, if a change in terminology is to be pursued, the results indicate that two issues be addressed: 1) the implication of harm associated with the term 'injury' should be addressed and mitigated in some manner and, 2) a terminology change should be first addressed by entities charged with nomenclature and policy.

        View Detailed Responses
      • 11/03/2017 3:35 PM | Anonymous

        The Quality Payment Program (QPP) Final Rule was released last night. We are still reviewing every detail and considering comments to submit, but below you will find some of the big points we have pulled out so far.

        • Threshold to avoid a penalty moves from 3 to 15 MIPS points
        • 2014 and/or 2015 CEHRT allowed but bonus ACI points available if use only 2015 CEHRT
        • Eligible clinicians or groups with <= $90K Part B allowable or <= 200 Part B beneficiaries excluded
        • Cost category counts for 10% of MIPS score
        • Cost category score will be calculated by Medicare Spending per Beneficiary (MSPB) and total per capita cost measures
        • CMS will calculate Cost measure “performance” - nothing for us to report for that category
        • Clinicians affected by Harvey, Irma, or Maria that do not submit 2017 MIPS data will not have a negative adjustment in 2019
        • Clinicians affected by Harvey, Irma, or Maria can file a hardship exception application for Quality, ACI, and CPIA categories for 2018 performance period
        • Still only allowed one submission method per category
        • Quality category moves from 60% of MIPS score in 2017 to 50% in 2018
        • Clinical Practice Improvement Activity category still counts 15% - can still avoid penalty with just a perfect CPIA score
        • Clinicians in practices of 15 or less are exempt from ACI category and that 25% moves to Quality category
        • Exceptional performance threshold remains 70 MIPS points
        • Option to participate as a Virtual Group
        • 2018 QPP Final Rule Reporting Periods: Cost - 12 mos, Quality - 12 mos, ACI - 90 days, CPIA - 90 days
        Links: Full Release / CMS Summary Sheet

        Nothing discussed in this communication guarantees coverage or payment. This is our interpretation of the Final Rule. Coverage and payment policies of governmental and private payers may vary from time to time and in different parts of the country. Questions regarding coverage and payment by a payer should be directed to that payer. APWCA does not claim responsibility for any consequences or liability attributable to the use of any of the information discussed in this communication.

      • 10/12/2017 8:59 AM | Anonymous

        With quality measure-based payment models now driving Medicare reimbursement under MACRA (the Medicare Access and CHIP Reauthorization Act), wound care practitioners have faced a unique challenge: few reportable quality measures relevant to wound care.

        A study recently published in the International Society For Pharmacoeconomics and Outcomes Research's Value in Health journal shows the full burden and cost of wound care in the US Medicare population, highlighting the need for CMS health policy makers to develop more appropriate quality measures, episode of care measures and reimbursement models for wound care. The findings - particularly the insights regarding the costs of diabetic foot ulcers and diabetic infections - are of particular interest to the podiatry community.

        The study "An Economic Evaluation of the Impact, Cost, and Medicare Policy Implications of Chronic Nonhealing Wounds" analyzed 2014 Medicare data and determined the cost of chronic wound care for Medicare beneficiaries in aggregate, by wound type, and by setting. The findings are compelling:

        • Chronic nonhealing wounds impact nearly 15% of Medicare beneficiaries (8.2 million).
        • A conservative estimate of the annual cost is $28 billion when the wound is the primary diagnosis on the claim. When the analysis included wounds as a secondary diagnosis, the cost for wounds is conservatively estimated at $31.7 billion.
          • Surgical wounds and diabetic foot ulcers drove the highest total wound care costs (including cost of infections).
          • On an individual wound basis, the most expensive mean Medicare spending per beneficiary was for arterial ulcers followed by pressure ulcers.
          • Hospital outpatient services drove the greatest proportion of costs - demonstrating a major shift in site-of-service costs from hospital inpatient to outpatient settings.
          • Surgical infections were the largest prevalence category, followed by diabetic wound infections.

        This documentation of the economic impact of nonhealing wounds can be meaningful from a policy perspective moving forward. "The true burden of wound care to Medicare has remained relatively hidden and have not been a focus from a public policy standpoint in the U.S. We are hopeful that documenting the significant economic cost and impact of chronic wounds can influence priorities for Federal research funding in this space and for innovative payment approaches by the CMS, including quality and performance measures within MACRA," noted lead study author Dr. Samuel Nussbaum, Schaeffer Center for Health Policy and Economics, University of Southern California.

        National quality measures have not been developed for use under MACRA's Merit-based Incentive Payment System (MIPS) that are relevant to the broad spectrum of wound care. With quality measure-based payment models driving Medicare reimbursement under MACRA, this is a problem for practitioners. "CMS needs to recognize the cost and prevalence of chronic wounds in the development of chronic care models and episodes of care. Chronic wounds can't be forgotten about if we want to drive better health outcomes and smarter wound care spending," said co-author Caroline Fife, MD, Medical Director, CHI St. Luke's Hospital (The Woodlands, Texas) and Executive Director, U.S. Wound Registry.

        The study was funded by the Alliance of Wound Care Stakeholders, an association of clinician associations and medical specialty societies focused on promoting quality care and access to products and services for people with wounds and the providers who treat them. The Alliance has been leading advocacy initiatives to educate policy makers and regulators about the importance of more meaningful quality measures for the wound care space. The American Professional Wound Care Association is a member of the Alliance.

        The full study is available online; the Alliance's comments to CMS seeking performance measures more relevant to wound care are posted on www.woundcarestakeholders.org.

        Downloads: Full Article (PDF) / Fact Sheet / News Release

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