April 23, 2018 | Today’s News

CMS issues proposed rule to improve transparency and reduce administrative burdens

A proposed rule from the U.S. Centers for Medicare & Medicaid Services (CMS) seeks to increase cost transparency and reduce administrative burdens on healthcare providers. Among other things, if adopted as written, the rule would:

• require online posting of hospital chargemasters
• remove certain measures from the Hospital Inpatient Quality Reporting IQR Program
• remove 10 measures from the Hospital Value-Based Purchasing Program
• rename the Meaningful Use program “Promoting Interoperability”

In addition, the proposal would overhaul the Medicare and Medicaid Electronic Health Record Incentive Programs to focus on interoperability, improve flexibility, relieve burden, and place emphasis on measures that require the electronic exchange of health information between providers and patients.

Read the CMS fact sheet…

Read the rule…

CMS seeks comments on direct provider contracting payment model

CMS is accepting comments on a CMS Innovation Center proposal for a direct provider contracting payment model. The agency states that such a model “would allow providers to take further accountability for the cost and quality of a designated population in order to drive better beneficiary outcomes,” and eliminate administrative burden for clinicians while offering increased flexibility to provide appropriate care. Comments on the proposal will be accepted through May 25.

Read more…

Read the CMS statement…

The U.S. Centers for Disease Control and Prevention (CDC) has issued an alert regarding potential life-threatening vitamin K-dependent antagonist coagulopathy associated with the use of synthetic cannabinoids. The agency states that, since March 8, 2018, at least 160 people have presented to healthcare facilities with serious unexplained bleeding, with the preponderant number of presentations in Illinois, with other cases reported in Florida, Indiana, Kentucky, Maryland, Missouri, Pennsylvania, Virginia, and Wisconsin. CDC recommends that providers, including orthopaedic and trauma specialists, “should be aware that patients with a history of synthetic cannabinoids (e.g., K2, Spice, and AK47) use may be anti-coagulated without clinical signs of coagulopathy. These patients should be screened for vitamin K-dependent anti-coagulant coagulopathy prior to their procedure.”

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A study conducted in Sweden and published in the April 18 issue of The Journal of Bone & Joint Surgery examines the long-term effects of distal radial fracture malunion. The authors conducted a prospective, cohort study of 63 adult patients with distal radial fracture who were treated with casting or percutaneous fixation. At 12–14-year follow-up, they found that 25 patients had malunion, 38 patients had osteoarthritis (OA), and nine patients had styloid nonunion. Compared against patients without malunion, the authors found that those with malunion had significantly worse Disabilities of the Arm, Shoulder and Hand (DASH) scores, and visual analog scale (VAS) pain and satisfaction scores. They found no significant difference across cohorts in range of motion or grip strength, and no significant association for OA and styloid nonunion with DASH scores, VAS pain or satisfaction scores, or grip strength.

Read the abstract…

An article in Medscape reports on a series of bills designed to target the opioid crisis, which are currently under consideration in the U.S. Senate and U.S. House of Representatives. The Senate Committee on Health, Education, Labor and Pensions voted unanimously to approve the Opioid Crisis Response Act of 2018, which among other things seeks to boost scientific research related to pain, to aid medical and law enforcement efforts to prevent and track misuse of prescription drugs, and to provide assistance to communities struggling with the consequences of addiction. Similarly, the House Energy and Commerce Committee is considering more than 60 separate bills that address painkillers and substance abuse.

Read more…  (registration may be required)

The American Association of Orthopaedic Surgeons (AAOS) sent letters to ranking members of both committees commenting on the various legislative proposals.

Read the letter to the Senate Committee on Health, Education, Labor and Pensions (PDF)…

Read the letter to the House Energy and Commerce Committee (PDF)…

The American Medical Association has released a report that offers a detailed look at how physicians—other than those in solo practice—are compensated by their practice. Among other things, the report finds that a majority of physicians are compensated via multiple methods, with only 19.0 percent reporting that their compensation was based exclusively on salary. The report also notes that compensation methods differed by ownership status—for owners, the average compensation share from personal productivity was 44.7 percent, compared to 22.3 percent for employees. In addition, only 5.2 percent of owners were exclusively compensated with a salary, compared to 27.7 percent of employees. The report states that nearly a fifth of employed physicians—who are often referred to as “salaried”—reported that more than half of their compensation was based on productivity.

Read more…

Read the report (PDF)…

Call for volunteers: Instructional Course Committees

May 11, 2018, is the last day to submit an application for a position on an Instructional Course Committee. Committee members grade Instructional Course Lecture applications in May and evaluate courses at the AAOS Annual Meeting in March. The following openings are available:

• Practice Management (chair, one member)
• Shoulder and Elbow (two members)
• Sports Medicine and Arthroscopy (one member)
• Tumor (three members)

Applicants for these positions must be active fellows with a practice emphasis in the relevant topic.

Learn more and submit your application…  (member login required)