The Exchange

Commentary and Observations from
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Health Policy and Trends

<a href='/the-exchange/cms-final-rule-np-and-pa-preceptor-documentation-updates--success-'>CMS Final Rule: NP and PA Preceptor Documentation Updates – Success!</a>

CMS Final Rule: NP and PA Preceptor Documentation Updates – Success!

On November 1, 2019, the Centers for Medicare and Medicaid Services (CMS) released the Medicare Physician Fee Schedule final rule, which will positively affect the NP and PA preceptor documentation burden. For those of you providing clinical teaching rotations for advanced practice registered nurse (APRN) and/or PA students, you may be aware that in March 2018 CMS reduced the documentation burden for physician preceptors. This change authorized teaching physicians to verify and sign student documentation components of evaluation and management (E/M) services rather than have to re-document the work themselves. Unfortunately, this created unintended consequences for APRN and PA preceptors and the students they supervise. more >

Found in: Health Policy and Trends

<a href='/the-exchange/prescription-drug-misuse-in-the-united-states'>Prescription Drug Misuse in the United States</a>

Prescription Drug Misuse in the United States

Narcotic prescription medications have important medical uses, but they also stimulate the reward center of the brain. In susceptible individuals, this can more >

<a href='/the-exchange/management-of-patients-with-suspected-evali'>Management of Patients with Suspected EVALI</a>

Management of Patients with Suspected EVALI

Over the last several years there has been a dramatic spike in individuals vaping, and we have witnessed the associated injuries—including burns and lung more >

<a href='/the-exchange/women-in-oncology'>Women in Oncology </a>

Women in Oncology

As a nurse practitioner, I practice in a predominantly female profession. However, I have seen a wave of symposia at recent major conferences that focus on more >

<a href='/the-exchange/how-have-carcinogens-tainted-our-generic-drug-supply-'>How Have Carcinogens Tainted Our Generic Drug Supply?</a>

How Have Carcinogens Tainted Our Generic Drug Supply?

In July 2018, the FDA announced that a known carcinogen, called N-Nitrosodiumdimethylamine, or NDMA, had been found in valsartan manufactured by Zhejiang more >

<a href='/the-exchange/the-real-risks-of-vaping-all-clinicians-must-ask-the-right-questions-and-warn-patients'>The Real Risks of Vaping: All Clinicians Must Ask the Right Questions and Warn Patients</a>

The Real Risks of Vaping: All Clinicians Must Ask the Right Questions and Warn Patients

Most of us have seen the recent news regarding the alarming rise of respiratory-related illnesses and deaths due to e-cigarettes, or vaping. For those not more >

<a href='/the-exchange/new-statement-related-to-hospitalized-heart-failure-patients'>New Statement Related to Hospitalized Heart Failure Patients</a>

New Statement Related to Hospitalized Heart Failure Patients

The American College of Cardiology has issued a new Expert Consensus Decision Pathway for the management of patients with heart failure. This newly released more >

<a href='/the-exchange/update-state-regulatory-environment-for-opioid-prescribing'>Update: State Regulatory Environment for Opioid Prescribing</a>

Update: State Regulatory Environment for Opioid Prescribing

As prescribers for patients with acute and chronic pain in primary care, NPs and PAs are very much aware of the national opioid epidemic, including ways in more >

<a href='/the-exchange/updated-beers-criteria-for-potentially-inappropriate-medication-use-in-older-adults'>Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults</a>

Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults

The American Geriatrics Society 2019 Updated Beers Criteria—updated from 2015—are designed to reduce older adults' drug-related problems including, but not more >

<a href='/the-exchange/team-based-care-latest-data-on-family-physician-pa-and-np-practices'>Team-Based Care: Latest Data on Family Physician, PA, and NP Practices</a>

Team-Based Care: Latest Data on Family Physician, PA, and NP Practices

A recent study published in Family Medicine demonstrates the positive impact on practice capacity and scope of practice of family physicians when more >

<a href='/the-exchange/preceptors-and-tax-credits-interprofessional-policy-change'>Preceptors and Tax Credits—Interprofessional Policy Change</a>

Preceptors and Tax Credits—Interprofessional Policy Change

This blog is information only and not to be construed for legal tax advice—you must consult your tax professional regarding personal tax advice. If more >

<a href='/the-exchange/how-do-drug-pricing-systems-work-if-there-is-more-competition-shouldn-t-the-list-price-go-down-'>How Do Drug Pricing Systems Work? If There Is More Competition, Shouldn’t the List Price Go Down?</a>

How Do Drug Pricing Systems Work? If There Is More Competition, Shouldn’t the List Price Go Down?

Have you ever noticed how much more expensive drug prices become every year? I think we have all noticed this increase, so this week I decided to look in to more >

<a href='/the-exchange/choose-wisely-as-to-when-you-schedule-your-medical-care'>Choose Wisely As To When You Schedule Your Medical Care</a>

Choose Wisely As To When You Schedule Your Medical Care

Most of us tend to need a pick-me-up—perhaps a cup of coffee—around mid- to late-afternoon. But a new study published by JAMA on May 10, 2019 in more >

<a href='/the-exchange/consider-deprescribing-in-our-older-adults'>Consider Deprescribing in Our Older Adults</a>

Consider Deprescribing in Our Older Adults

We all have patients in our practices who are older and on numerous medications. They are stabilizing their problems but are faced with the reality of nearing more >

<a href='/the-exchange/advanced-practice-providers-and-liability-risk'>Advanced Practice Providers and Liability Risk</a>

Advanced Practice Providers and Liability Risk

It is a misconception that advanced practice providers can’t get sued because any errors are a physician’s responsibility. PAs and NPs can and do make more >

<a href='/the-exchange/national-stop-the-bleed-month'>National Stop the Bleed Month</a>

National Stop the Bleed Month

Did you know that May 2019 is the first ever National Stop the Bleed Month? Also, May 23 is the second annual Stop the Bleed® Day. So what is “stop the more >

<a href='/the-exchange/hypertension-in-the-pediatric-population'>Hypertension in the Pediatric Population</a>

Hypertension in the Pediatric Population

The prevalence of systemic hypertension (HTN) in the pediatric population is now commonly observed to be increasing, especially in view of the growing more >

<a href='/the-exchange/using-policy-to-impact-hpv-vaccine-rates'>Using Policy to Impact HPV Vaccine Rates</a>

Using Policy to Impact HPV Vaccine Rates

For more than 10 years we have had a safe and effective vaccine that can prevent several types of cancer. I understand the reluctance to accept a vaccine when more >

<a href='/the-exchange/universal-influenza-vaccine-begins-phase-i-clinical-trials'>Universal Influenza Vaccine Begins Phase I Clinical Trials </a>

Universal Influenza Vaccine Begins Phase I Clinical Trials

The National Institutes of Health have begun the first clinical trial of an innovative universal influenza vaccine candidate. A Phase I trial will examine the more >

<a href='/the-exchange/patient-autonomy-keeping-our-patients-self-determination-preserved'>Patient Autonomy: Keeping Our Patients’ Self-Determination Preserved</a>

Patient Autonomy: Keeping Our Patients’ Self-Determination Preserved

If you’ve practiced in medicine for at least 20 years, you may remember the case of Terri Schiavo, a woman in her 20s who was in a coma for more than a more >

<a href='/the-exchange/states-involvement-with-medicaid-expansion'>States' Involvement With Medicaid Expansion</a>

States' Involvement With Medicaid Expansion

For a little over 50 years, Medicaid has provided health care as a stop gap to millions of people. With the passage of the Affordable Care Act (ACA), few more >

<a href='/the-exchange/here-we-go-again-measles-in-seattle-this-time'>Here We Go Again: Measles in Seattle This Time</a>

Here We Go Again: Measles in Seattle This Time

As of January 31, 2019, there were 42 confirmed cases of measles in the Pacific Northwest. This includes 41 cases in Clark County, the epicenter for the more >

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