Trends in Registered Dietitian Nutritionists' Knowledge and Patterns of Coding, Billing, and Payment.

The US health care system has been undergoing substantial changes in reimbursement for medical and nutrition services. These changes have offered opportunities and challenges for registered dietitian nutritionists (RDNs) to bill for medical nutrition therapy and other nutrition-related services. During the past 10 years, the Academy of Nutrition and Dietetics has periodically surveyed RDNs providing medical nutrition therapy in ambulatory care settings to learn about their knowledge and patterns of coding, billing, and payment for their services. In 2018, the Academy of Nutrition and Dietetics conducted the latest iteration of this survey. This article compares the results of the 2008, 2013, and 2018 surveys to examine changes in RDNs' knowledge of billing code use and reimbursement patterns over time; understand the potential influences on coding and billing practices in a changing health care environment; and understand the effects of newer practice settings and care delivery models on billing and reimbursement for medical nutrition therapy services. Results from these surveys demonstrate that during the past 10 years RDNs' knowledge of billing and coding has been stable and very low for RDNs not in supervisory roles or private practice. RDNs reported an increase in providing medical nutrition therapy services to patients with multiple conditions. Since 2013, a dramatic increase was noted in the reported proportion of reimbursement from private/commercial health insurance plans. Results also indicate that most RDNs are not aware of changes in health care payment. Individual RDNs need to understand and be held accountable for the business side of practice and their value proposition in today's health care environment.

[Biotherapies, immunotherapies, targeted therapies, biopharmaceuticals which word should be used?]. / Biothérapies, immunothérapies, thérapies ciblées, biomédicaments - De quoi faut-il parler ?

The ability to accurately describe and name medical advances is a prerequisite to foster public debates with scientists and physicians, and favour faith over fear among patients and citizens. Therapeutic antibodies are a good example of a medical breakthrough which has met with considerable clinical success, and which terminology has changed over the years. If the appellation serotherapy was appropriate a century ago, it has become obsolete. Recent names such as biotherapy, immunotherapy, targeted therapy, biopharmaceuticals have been introduced and are now commonly used, each of those can apply to therapeutic antibodies. It is thus interesting to question the real meaning of these different appellations. Our goal in this manuscript is to analyse the genesis of these terms but also to suggest how to simplify the terminology: biotherapy or targeted therapy need to be eliminated, as well as immunotherapy when communicating with non scientific public. It is recommended to favour the term biopharmaceuticals (biomédicaments in French), which clearly indicates the origin of these molecules, intermediate between chemical drugs and living biologics, whose borders need to be accurately defined also.