Related Experiment Video
Updated: Jun 14, 2026

Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood
Published on: October 12, 2012
Penny-wise, pound-foolish? Highmark Medicare Services' proposal for anticoagulation clinic reimbursement
Michael B Streiff1, Peggy S Kraus, Peter Pronovost
1Department of Medicine and Pathology, Johns Hopkins Medical Institutions, Baltimore, MD 21205, USA. mstreif@jhmi.edu
Abstract:
Warfarin is prescribed to millions of Americans for the management of thromboembolism and is a common cause of adverse events. Optimizing warfarin therapy has been the focus of national quality improvement initiatives. Anticoagulation clinics have been demonstrated to result in better outcomes than usual care. Nevertheless, Highmark Medicare Services recently issued a provider bulletin on anticoagulation clinic visit reimbursement that we believe will adversely affect the care for patients on anticoagulation. In this commentary, we review the potential unintended consequences of this proposal and offer alternatives that we believe will increase the efficiency and quality of anticoagulation management.
Related Concept Videos
Anticoagulant Drugs: Low-Molecular-Weight Heparins
Venous Thrombosis III: Interprofessional Care
Peripheral Artery Disease III: Interprofessional Care
Venous Thrombosis IV: Nursing Management
Preventive Healthcare Services
Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...