August 30, 2017

Today’s Top Story
OIG: During first 3 years of MSSP, ACOs reduced spending and improved quality overall.
A report from the U.S. Department of Health and Human Services (HSS) Office of Inspector General (OIG) suggests that accountable care organizations (ACOs) may help reduce spending and improve quality. The agency analyzed spending and quality data to determine the extent to which ACOs reduced Medicare spending and improved quality during the first 3 years of the Medicare Shared Savings Program. The researchers found that 428 participating Shared Savings Program ACOs served 9.7 million beneficiaries during that period. Over the study term, they found that ACOs improved their performance on 82 percent of the individual quality measures, and outperformed fee-for-service providers on 81 percent of quality measures. The agency notes that a small subset of high-performing ACOs reduced spending by an average of $673 per beneficiary for key Medicare services during the review period, while other Shared Savings Program ACOs and the national average for fee-for-service providers showed an increase in per beneficiary spending for key Medicare services.
Read more…
Read the complete report (PDF)…

Other News

Study: How do MIPO and minimal ORIF compare for treatment of simple distal tibial fracture?
Findings from a study published online in the Journal of Orthopaedic Trauma suggest that both minimally invasive plate osteosynthesis (MIPO) and minimal open reduction and internal fixation (ORIF) are associated with quality outcomes for simple distal tibial fracture. The authors conducted a prospective, randomized trial of 58 patients treated with either MIPO (n = 29) or minimal ORIF (n = 29). They found that mean time to union was 17.4 weeks in the MIPO cohort and 16.3 weeks in the minimal ORIF cohort, with one case of delayed union and one case of superficial infection in each group. The authors note that the radiation exposure time was shorter in the minimal ORIF group than in the MIPO group, and that minimal ORIF did not result in increased rates of infection and wound dehiscence.
Read the abstract…

Study: Following ACL reconstruction, index knee at increased risk of subsequent meniscal surgery compared to contralateral knee.
A study published online in The American Journal of Sports Medicine suggests that, for patients who undergo anterior cruciate ligament (ACL) reconstruction, risk of subsequent meniscal surgery may be higher in the index knee compared to the contralateral knee. The research team conducted a cohort study of 4,087 patients, 32 (0.78 percent) of whom underwent subsequent meniscal surgery in the index knee and 9 (0.22 percent) of whom underwent such surgery in the contralateral knee. They noted a 3.73 relative risk of subsequent meniscal surgery in the index knee compared with the contralateral knee, or a 0.57 percent absolute risk difference. After adjustment, the research team found that compared with bone–patellar tendon–bone (BPTB) autograft, allograft and hamstring autograft were risk factors for subsequent meniscal surgery in the index knee.
Read the abstract…

Study: Approximately 6 percent of primary lumbar diskectomy patients undergo revision at 7 years.
A study published online in the journal Clinical Orthopaedics and Related Research examines rates for revision diskectomy. The researchers reviewed data on 7,520 primary lumbar diskectomy patients from two national insurance databases in the United States. At 7-year follow-up, they found that revision rates ranged from 5.6 percent to 6.2 percent, with a total of 452 patients having undergone revision diskectomy. The researchers noted survivorship was lower for patients younger than 65 years, even when nondiskectomy lumbar surgeries were included. They found no difference in revision diskectomy rates or additional nondiskectomy lumbar surgery rates across geographic regions.
Read the abstract…

AAOS to host free webinar on writing a publishable manuscript.
An upcoming AAOS webinar will focus on tips for overcoming the unique challenges associated with preparing a publishable manuscript. Topics to be discussed include conducting a literature review, writing case reports and case series, keys to publishing your manuscript, and understanding the peer review process. The webinar will take place Wednesday, Sept. 6, from 7:30 p.m. to 8:30 p.m. CT.
Register for the webinar…

September AAOS Now is available online.
AAOS members will soon receive the print edition of the September issue of AAOS Now, but the electronic edition is already available on the AAOS Now website and on iOS and Android devices through the AAOS Access app. This month’s issue includes a look at the challenges of treating human immunodeficiency virus (HIV)-positive orthopaedic patients, an article on preoperative opioid use among patients undergoing anterior cruciate ligament reconstruction, an examination of telehealth in orthopaedic practice, and much more.
Read more…
Read “HIV and the Orthopaedic Patient”…
Read “Preoperative Opioid Use Increases Risk of Postoperative Narcotic Demand Following ACLR”…
Read “Telehealth at a Tipping Point”…
Read AAOS Now in the Access app…

Call for volunteers: Pain Management Best Practices Inter-Agency Task Force.
AAOS seeks to nominate a member to the HHS Pain Management Best Practices Inter-Agency Task Force. The task force will provide advice and recommendations for development of best practices for pain management and prescribing pain medication, and a strategy for disseminating such best practices to relevant federal agencies and the public. Applicants for this position must be active fellows, candidate members, candidate members osteopathic, candidate member applicants for fellowship, or candidate member applicants for fellowship osteopathic. In addition, all applicants must provide the following: an online AAOS CAP application, a current curriculum vitae, and a letter of interest highlighting his or her expertise in the subject area. All supporting materials must be submitted to Kyle Trivedi by Sept. 18, 2017, at 11:59 p.m. CT, at:  trivedi@aaos.org.
Learn more and submit your application…(member login required)

 

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