Rising Costs and Diminishing Surgeon Reimbursement From Primary to Revision Total Hip and Knee Arthroplasty: An Analysis of Medicare Advantage and Commercial Insurance
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Abstract:
Revision total joint arthroplasty (rTJA) is a resource-intensive procedure addressing failed primary total joint hip (total hip arthroplasty [THA]) and knee arthroplasty (total knee arthroplasty [TKA]). Despite predictions of increased demand, reimbursement for rTJA has not kept pace with increasing costs and may be insufficient compared with primary procedures. The study aimed to highlight the diminishing surgeon reimbursement between primary and revision THA (rTHA) and TKA.Keywords:
Reimbursement
Joint arthroplasty
Pace
With keeping pace with the times,Marxism shows great vigor and power.And those outstanding Marxists advance the development of Marxism by sticking to keeping pace with the times.TheThree Representsis another brilliant example of Marxism in keeping pace with the times.We should try to explore howto grasp and stick to the spirit of keeping pace with the times in practice.
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Carry through three representations lies in insisting pace with the time, keeping pace with the is the all theories and the characteristic of period which our work must show on, taking hold of law and do well creating, We should bring the work of quitting and retiring a new situation, we must do the following well: insisting the new idea of pace with the time, making the old comrades' political treatment specific, the spirit state pace with the time and widening the new way in the field of thought and political work, helping forward the spirit of pace with the time strongly, renewing the service concept that regarding persons as core continuously.
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Marxism has the nature of keeping pace with the times. Seen from the history of Marxism, keeping pace with the times is the major feature; seen from the inner need of Marxism, keeping pace with the times is the essential nature; seen from the development of Marxism, keeping pace with the times is the inevitable requirement; seen from historic mission, keeping pace with the times is the eternal theme.
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Health care reimbursement reform is underway as part of a national effort to enhance quality outcomes and bring spiraling health care costs under control. Implications of pay-for-performance reimbursement are discussed along with ways to prepare for changes in APN reimbursement.
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The internal relations between 搆eep pace with the times?and the 揟hree Represents?should be acknowledged, in the basic commander standpoint of the 揝peech on July1st? Marxism-Leninism is the science developing with the times. It is put forward that the thoughts of keeping pace with the times should be the main condition for cadres of colleges and universities. The cadres personnel system reform should be accelerated and deepened according to the spirit of the 揟hree Represents?
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Deep infection after total hip arthroplasty is one of the most serious post operative complications. Treatment of infection of the hip joint can be made very difficult by poor response to antibiotic therapy. Infection rates of total hip arthroplasty have decreased due to prophylactic antibiotics, sterilization of surgical instruments, cleaner operation environments, Improvement of surgical methods and proper patient selection. Recently, post operative infection rates of primary or revision arthroplasties were reported to still be as high as 1% to 2%. Therefore, the aim of this article is to review the recent literature and to evaluate the cause, environment diagnosis and treatment of infection after total hip arthroplasty.
Joint arthroplasty
Hip Arthroplasty
Sterilization
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NCMS net direct reimbursement is activated officially,which changed the traditional reimbursement pathway,and promote the management.In order to insure the net direct reimbursement to run in efficient,stable and sustainable circumstance,the problems existing in net direct reimbursement must be modified through unify information platform and reimbursement rate.
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Aims:1. To study the indication of TKA in our setup.2. To evaluate the results clinically by assessing the functional improvement of the patients with reference to pain, walking ability and range of motion. To study the implications associated with this procedure Materials and Methods:We are reporting the retrospective study and the early results of 28 knees of Total condylar knee arthroplasty using either with or without posterior stabilizing designs.28 knees in 25 patients who visited the department of orthopaedics at Bowring and Lady Curzon hospitals.Bangalore Medical college.Bangalore, during the year 2001 -2003.Have been selected with appropriate indications.The patients with severe knee arthritis and intractable pain were screened consecutively to select the patients.The patients with serious medical illness, infected arthritis, haemophilic arthropathy, charcoat arthropathy, and extreme complex deformed knees and follow up less than 6 months were excluded.Of the selected patients, 10 were RA, 14, were OA, and 1 had septic arthritis sequelae.Results: There were 19 (76%) females and 6(24%) males.Right knee predominates (14-56%) than left (8-32%) and bilateral (3-12%).The unilateral replacement did pose a problem in clinical evaluation and may have an effect on long term results.As two cases could not be followed up after 6months, evaluation was done for 26 knees in 23 patients.Pre-operatively all of our patients had moderate to severe pain and 38.5% had rest pain.Post-operatively only 19% had mild pain.Pre-operatively there were no excellent knees .11.6% of the knees scored good, 26.9 % scored fair and 61.5% scored poor.Post-operatively 65% of the knees scored excellent, 16% good and 19% scored fair Conclusions: Our study of total condylar prosthesis series demonstrates that total condylar prosthesis is reliable, provide pain relief, average 90-95 motion and aood function.
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