Fall Prevention

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Prevent Falls and Keep Your Patients Safe

Give your patients the peace of mind that comes from the proper diagnosis of balance issues.

The risk of falls for many aging patients can be reduced through correct diagnosis and treatment. Up to 50% of patients have a vestibular problem that accounts for their risk of falling. This problem can be quickly identified and remedied with the right equipment.

Falls are the leading cause of death, injury, and hospital visits by seniors. As many as 1 in 3 seniors will fall this year, and a single fall can dramatically decrease the quality of life, patient confidence, increase pain, cost thousands of dollars, and result in a shorter life span. Medicare has taken notice of this and is implementing physician incentives plus, under the Affordable Care Act, will begin requiring fall prevention screening and testing as part of both the initial patient checkup and annual wellness visits.

Give your patients the peace of mind that comes from the proper diagnosis of balance issues and ensure that your practice offers patients the highest standard of care, all while staying Medicare compliant. The VATplus Vestibular Autorotation Test is a simple, non-invasive test that takes less than 10 minutes and can be performed in nearly any exam room by your MA staff. The unit is portable, and enables you to provide screening and treatment to your patients anywhere, including nursing homes and long term care facilities!

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Medicare and private insurances both reimburse 100% of the fees for this testing, and our convenient, easy leasing options mean that your practice can realize an excellent return on your investment and generate a substantial monthly revenue.

Health and confidence are the most valuable commodities anyone can have – VATplus fall prevention screening enables you to identify issues and then promote lifelong behavior modification techniques.

The Best Diagnostic Tool for Your Patients

Important Facts & figures:

  • Inner ear disorders are the leading cause of falls amongst our aging population.
  • 33% of all seniors will fall this year.
  • Over 69 million people suffer from vestibular dysfunction, which often goes unnoticed until the first emergency or fall.
  • After identifying the issue, highly-effective treatments exist for vestibular disorders.
  • On average, it costs Medicare $19,440 when a senior falls. Moreover, the American Geriatric Society and Medicare report that 85% of senior falls occur as a result of some type of vestibular issue.
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Medicare PQRS and What It Means to You

  • Incentives for testing: Current Medicare standards offer incentives to physicians that participate in the Physician Quality Reporting Standards program. This program includes fall screening (questionnaire) and testing, if indicated.
  • Penalties for non-compliance: Beginning in 2015, Medicare will penalize practices that do not include fall screening as part of the regular required visits for Medicare patients.
  • VATplus meets the need: Our consultants will provide you with questionnaires that meet the standard for fall screening. If the screening indicates a patient may be at risk of falling, Medicare and all private insurances cover diagnostic testing of vestibular function.
  • A healthier, longer life for patients:  Should a patient be diagnosed with vestibular disorder there are number of at-home and in-office treatments that are non-invasive and have been shown to be effective at improving balance and reducing falls.

The Profitable Solution for Your Practice

The VATplus Test is simple to perform, mobile, compact, and offers an excellent return on investment.

  • Offer your patients the confidence and sense of security they need with a simple, 10 minute test they can take in your convenient and comfortable clinic setting.
  • Fully reimbursable insurance codes that have been tested and proven.
  • Easy to navigate leasing options available.
  • At a low rate of testing (4 patients a week), the equipment will pay for itself in just 6 months.
  • Testing just 1 patient a day offers an additional annual revenue of over $150,000!

Start-up And Implementation

How Do I Get Started?

Your Certified Ancillary Consultant will work with your practice and the vendor to order the VATplus testing equipment and, if you would like to finance this equipment, AMS offers easy equipment financing solutions.

Training on Delivery

You can expect to receive your equipment within 10 business days of ordering. A specialist from Western Systems Research will come to your practice with the equipment to give you and your staff complete training on proper testing procedures. Your AMS Certified Consultant will then assist with the ongoing optimization of this important testing device in your practice.

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CPT Codes

  • All codes are provided and proven
  • Expected reimbursements from both private insurance and Medicare
  • Average reimbursement of $525 after initial testing and follow-up appointment

Coding:

  • 92541: Spontaneous nystagmus test, including gaze and fixation nystagmus, with recording
  • 92542: Positional nystagmus test, minimum of 4 positions, with recording
  • 92543: Caloric vestibular test, each irrigation, with recording
  • 92544: Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation
  • 92545: Oscillating tracking test, with recording
  • 92546: Sinusoidal vertical axis rotational testing
  • 92547: Use of vertical electrodes (list separately in addition to code for primary procedure)
  • 92548: Computerized dynamic posturography
  • 92540: Basic vestibular evaluation

1) Order your VATplus device – financing options are available

2) Begin to offer every patient the fall screening questionnaire as part of their regular intake paperwork

3) Learn how to use your new equipment from the delivering specialist – this test can be performed by anyone on your staff at MA level or above.

4) Starting from the list of patients who have completed the questionnaire, begin testing. Medicare and private insurance are billed with the proven codes.

5) After 85 patients have been tested and followed up, your device has been paid for. Enjoy a new revenue stream of $150,000 or more a year!

Fall Screening Questionnaire

A Sample Questionnaire

  • Have you fallen in the past year?
  • Do you feel dizzy or off balance if you make a sudden change in movement, such as bending down or quickly turning?
  • Do you have any hearing loss?
  • Do you require assistance to walk, such as use of a walker, wheelchair, or a person supporting you?
  • Do you have balance problems when you are walking or climbing stairs?

Offer the Follow-Up In-house

If the answer to any of the questions above is yes, your patient may suffer from vestibular dysfunction and is a candidate for the VATplus test to determine whether or not further treatment is necessary. By offering this simple screening to your patients as a standard part of every visit, your clinic will stay Medicare compliant.

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Your Certified Ancillary Consultant will provide you with a copy of this questionnaire to begin offering to your patients. If you find that a portion of your patient population suffers from balance issues and are at risk for falling, the VATplus testing equipment is the right choice for your practice.

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The Bottom Line

We recommend incorporating these screening questionnaires into your practice the day you order your VATplus. This will allow your practice to line up a number of testing candidates right away so when the equipment arrives in 7-10 business days you will be ready to begin testing immediately

If your practice tests one patient a day it will be making an additional average revenue of:

  • $500 a day
  • $10,000 a month
  • $120,000 a year

If you have chosen to finance the equipment for $850 a month your practice will be making $9,150 every month.

And at just 2 tests performed daily, your practice will see an additional $240,000 per year.

The VATplus equipment, priced currently at $42,000, is paid for after the first 85 patients have been tested.

Facts & Figures

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Fall Prevention Statistics

Each year, millions of adults aged 65 and older fall. Falls can cause moderate to severe injuries, such as hip fractures and head traumas, and can increase the risk of early death. Fortunately, falls are a public health problem that is largely preventable.

How big is the problem?

  • One out of three adults age 65 or older falls each year, but less than half talk to their healthcare providers about it.
  • Among older adults, falls are the leading cause of both fatal and non-fatal injuries.
  • In 2012, 2.4 million non-fatal falls among older adults were treated in emergency departments and more than 722,000 of these patients were hospitalized.
  • In 2012, the direct medical costs of falls, adjusted for inflation, was $30 billion

What outcomes are linked to falls?

  • Twenty to thirty percent of people who fall suffer moderate to severe injuries such as lacerations, hip fractures, and head traumas. These injuries can make it hard to get around or live independently, and increase the risk of early death.
  • Falls are the most common cause of traumatic brain injuries (TBI). In 2000, 46% of fatal falls among older adults were due to TBI.
  • Most fractures among older adults are caused by falls. The most common are fractures of the spine, hip, forearm, leg, ankle, pelvis, upper arm, and hand.
  • Many people who fall, even if they are not injured, develop a fear of falling. This fear may cause them to limit their activities, which leads to reduced mobility and loss of physical fitness and, in turn, increases their actual risk of falling.

Who Is At Risk?

Fall-Related Deaths

  • The death rates from falls among older men and women have risen sharply over the past decade.
  • In 2011, about 22,900 older adults died from unintentional fall injuries.
  • Men are more likely than women to die from a fall. After taking age into account, the fall death rate in 2011 was 41% higher for men than for women.
  • Older whites are 2.7 times more likely to die from falls than their black counterparts.
  • Rates also differ by ethnicity. Older non-Hispanics have higher fatal fall rates than Hispanics.

Fall Injuries

  • People age 75 and older who fall are four to five times more likely than those age 65 to 74 to be admitted to a long-term care facility for a year or longer.
  • Rates of fall-related fractures among older women are more than twice those for men.
  • Over 95% of hip fractures are caused by falls. In 2010, there were 258,000 hip fractures and the rate for women was almost twice the rate for men.
  • Older whites are 2.7 times more likely to die from falls as their black counterparts.
  • Rates also differ by ethnicity. Older nonHispanics have higher fatal fall rates than Hispanics.

Current Medical Landscape

Vestibular Disorders: An Overview

The vestibular system includes the parts of the inner ear and brain that process the sensory information involved with controlling balance and eye movements. If disease or injury damages these processing areas, vestibular disorders can result. Vestibular disorders can also result from or be worsened by genetic or environmental conditions, or can occur for unknown reasons.

The most commonly diagnosed vestibular disorders include benign paroxysmal positional vertigo (BPPV ), labyrinthitis or vestibular neuritis, Ménière’s disease, secondary endolymphatic hydrops, and perilymph fistula. Vestibular disorders also include superior canal dehiscence, acoustic neuroma, ototoxicity, enlarged vestibular aqueduct, and mal de débarquement. Other problems related to vestibular dysfunction include migraine associated vertigo and complications from autoimmune disorders and allergies.

Prevalence and Incidence

Prevalence and Incidence

From the Vestibular Disorders Association: https://vestibular.org

Because of difficulties posed by accurately diagnosing and reporting vestibular disorders, statistics estimating how common they are, how often they occur, and what social impacts they have range widely. Yet even the lowest estimates reflect the fact that vestibular disorders occur
frequently and can affect people of any age.

One recent large epidemiological study estimates that as many as 35% of adults aged 40 years or older in the United States—approximately 69 million Americans—have experienced some form of vestibular dysfunction. According to the National Institute on Deafness and
Other Communication Disorders (NIDCD), a further 4% (8 million) of American adults report a chronic problem with balance, while an additional 1.1% (2.4 million) report a chronic problem with dizziness alone. Eighty percent of people aged 65 years and older have experienced dizziness, and BPPV, the most common vestibular disorder, is the cause of approximately 50% of dizziness in older people. Overall, vertigo from a vestibular problem accounts for a
third of all dizziness and vertigo symptoms reported to health care professionals.

Symptoms of chronic dizziness or imbalance can have a significant impact on the ability of a disabled person to perform one or more activities of daily living such as bathing, dressing, or simply getting around inside the home, affecting 11.5% of adults with chronic dizziness
and 33.4% of adults with chronic imbalance. The painful economic and social impacts of dizziness are significantly underestimated.

Vestibular disorders not only profoundly affect adults, but also children. Once thought to be exceptionally rare, pediatric vestibular disorders are receiving increasing attention from clinicians as an overlooked problem. In addition to impairments of motor development and
balance, vestibular deficits may cause poor gaze stability that inhibits children from learning to read. Despite new awareness of pediatric vestibular disorders, children are currently not typically screened for them and, as a result, frequently fail to receive treatment for their symptoms.