Video Archives

2025 Medicare Part D Changes: Overview of the 2025 Plan

Posted by Mark N. Painter, CPMA, MBS | Oct 2024

Mark N. Painter, CPMA, Managing Partner, Consulting LLC, CEO, PRS Urology Service Corporation, Vice President of Coding and Reimbursement Information and
CEO Relative Value Studies, Inc. reviews upcoming 2025 Medicare Part D changes and what they aim to achieve. This 13-minute discussion goes into detail of each new update to Medicare Part D, including the reduction of the maximum out-of-pocket expenditure, the Medicare Prescription Payment Plan (MPPP), and “Likely to Benefit Letter” and how these can affect different patients, including those that are eligible for grants or subsidies.
Dr. Pohlman then brings up emerging complementary tests that mitigate the weaknesses of PSA alone, like the EpiSwitch® Prostate Screening (PSE) Blood Test. He explains that the EpiSwitch® PSE combines five epigenetic biomarkers with a standard PSA test in prostate cancer screening. He briefly discusses how the simplified test can be implemented in practice and how the test results are quickly and clearly delivered in patient-friendly formats to facilitate shared decision-making.

Dr. Pohlman then discusses the validation processes behind the EpiSwitch® PSE test, including its high accuracy, specificity, sensitivity, and positive/negative predictive values, which reduce the need for unnecessary prostate biopsies. He presents data supporting the benefits of using non-invasive biomarker tests like the EpiSwitch® PSE test in prostate cancer screening prior to MRI and/or prostate biopsy.

Dr. Pohlman concludes by presenting case studies where the EpiSwitch® PSE test would have prevented unnecessary biopsies and MRIs. He discusses his practice’s success in using the EpiSwitch® PSE tests to screen for prostate cancer without defaulting to invasive testing.

Emerging Therapies for Female SUI – Myosites, ACT

Posted by Michael P. Feloney, MD | Oct 2024

Michael P. Feloney, MD, focuses on Adjustable Continence Therapy (ACT) for women, specifically dual-balloon adjustable continence therapy. Dr. Feloney is noted for his experience with ACT, particularly during the initial investigational trials in the early 2000s. In this 12-minute presentation, Dr. Feloney describes the implantation procedure and provides photographs and graphics illustrating the correct placement of the silicone elastomer balloons.
A notable feature of this therapy is its adjustability. Once the balloons are in place, adjustments can be made post-operatively in the office, allowing for fine-tuning based on the patient’s response. Feloney emphasizes this advantage and its potential to enhance improved continence.
Dr. Felony addresses complication rates and notes that the rates of intraoperative perforations decrease with increased experience. The therapy, currently approved in Europe, Canada, Australia, and New Zealand, shows promise as a minimally invasive option for women with recurrent stress urinary incontinence who have failed previous surgeries.

Update on PROBASE Trial: Baseline PSA in Young Men (Aged 45 and 50)

Posted by Jeffrey M. Spier, MD | Oct 2024

Jeffrey M. Spier, MD, focuses on reimbursement, healthcare policy, and the role of advocacy in the current urology healthcare landscape. In this 10-minute presentation, Spier highlights LUGPA, which represents independent urology practices, promoting best practices, business acumen in urology, and policy advocacy.

Spier emphasizes the importance of urologists and healthcare professionals engaging in legislative advocacy to address issues such as reimbursement cuts, regulatory burdens, and rising operational costs. He notes that healthcare consolidation can negatively impact patient care and stresses the need for reform, particularly in areas like the Medicare fee schedule.

Spear advocates for unity within the urology community. He remains optimistic, calling for collective efforts to secure better outcomes for both physicians and patients while urging professionals to engage at local and national levels to make meaningful change.

The Value of Making Your Patient Stone Free

Posted by Mathew Sorensen, MD, MS, FACS | Oct 2024

Mathew Sorensen, MD, MS, FACS, examines the management of asymptomatic small kidney stones, particularly when discovered incidentally during imaging or when patients undergo surgery for a primary stone. There is a noted clinical debate on whether these additional, often small, stones warrant treatment.

In this 14-minute talk, Dr. Sorensen highlights that residual fragments frequently persist after lithotripsy, posing potential risks, including emergency visits or further surgeries. A multicenter randomized clinical trial, published in the New England Journal of Medicine, sought to clarify this issue. The results show a significantly lower relapse rate (16%) in the treatment group compared to the control group (63%)suggesting a substantial benefit in reducing future stone-related events. The study underscores the evolving approach in urology towards more proactive treatment of small stones, facilitated by less invasive technologies.

Alan Partin Lecture: The Genomics and Natural History of Visible vs. Invisible Cancers

Posted by Laurence Klotz, MD, FRCSC | Oct 2024

Laurence Klotz, MD, FRCSC, presents the newly-emerging and provocative concept of MRI visibility as a predictor of prostate cancer tumor aggressivity in the Alan W. Partin Distinguished Lecture at IPCU 34. Given that more definitive data on the subject develops, and the urological community accepts it, this could imply significant changes to practice.

Currently, the concern over invisible cancers drives a lot of interventions, such as systemic biopsies in patients who have already undergone targeted biopsies and/or received negative imaging results. Patients on active surveillance derive anxiety from the possibility of having untreated occult cancer.

The clinical implication of imaging-based monitoring has many advantages, such as psychological benefit to the patient, and reduced cost and burden of care from avoiding systematic biopsies. Recent genomic and clinical studies support the idea that tumors invisible on MRI imaging have much more favorable genetics and natural history tha