Today’s Top Story

HHS secretary supports reducing restrictions on physician-owned hospitals

Modern Healthcare reports that, in a hearing before the U.S. House of Representatives Committee on Ways and Means, U.S. Department of Health and Human Services (HHS) Secretary Alex Azar stated that he would support reducing restrictions placed on physician-owned hospitals under the Affordable Care Act (ACA). The ACA effectively prevents the establishment of new physician-owned hospitals by banning them from accepting Medicare and Medicaid. Existing physician-owned hospitals that seek to expand must meet certain requirements and request an exception from the HHS secretary. “I commit to work with [legislators] on any changes we can make to make sure we are allowing good competition allowing physician-owned, or other-owned, facilities to compete and deliver the highest quality, low-cost care to our beneficiaries,” Mr. Azar said.

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Watch the hearing and review the testimony…


The American Association of Orthopaedic Surgeons (AAOS) has advocated for both HHS and the U.S. Congress to address this issue.

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Other News

CMS: National health expenditure growth projected to outpace GDP over next 10 years

A report from the U.S. Centers for Medicare & Medicaid Services (CMS) Office of the Actuary projects national health expenditure growth in average 5.5 percent annually from 2017 through 2026. The agency notes that the growth in national health spending is projected to be faster than projected growth in gross domestic product (GDP) by 1 percent over the same period, with the health share of GDP projected to rise from 17.9 percent in 2016 to 197 percent in 2026. CMS states that the growth is expected to be driven primarily by fundamental economic and demographic factors, such as trends in disposable personal income, increases in prices for medical goods and services, and shifts in enrollment from private health insurance to Medicare.

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Study: Maladaptive pain-related responses may impact pain and performance levels of TKA patients

Findings from a study published online in the journal Clinical Orthopaedics and Related Research suggest that surgeons should consider certain pain-related responses when assessing patients prior to total knee arthroplasty (TKA). The authors conducted a cross-sectional analysis of 384 TKA patients with moderate to high levels of pain catastrophizing. They found that higher guarding scores and higher pain catastrophizing were associated with worse Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, while no adaptive responses were associated with improved WOMAC pain or physical performance scores. The authors note that maladaptive responses were also more consistently associated with worse self-reported and performance-based measure scores, but adaptive responses did not associate with better scores. “Future intervention-based research should target this trio of maladaptive pain responses to determine if intervention leads to improvements in postsurgical health outcomes,” the authors write.

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CMS to host webinar on MACRA Patient Relationship Categories and Codes

CMS will host a webinar designed to provide guidance to clinicians and other stakeholders on classifying patient relationships, for which the agency implemented an initial voluntary reporting period beginning Jan. 1, 2018. The webinar will include real-world examples of clinical scenarios to illustrate how Patient Relationship Categories and Codes work, a review of the statutory context and policy principles used in their development, and opportunities for attendees to ask questions. The webinar will be held Wednesday, Feb. 21, 2018, from 2 p.m. to 3:30 p.m. ET.

Learn more and register for the webinar…

In the States


The New York Times reports that HHS Secretary Azar plans to “closely scrutinize” a plan by Idaho to allow the sale of insurance that does not comply with the ACA. Mr. Azar said he had seen news reports of the plan, but the state had not asked the federal government for a waiver of ACA requirements. The governor of Idaho recently issued an executive order to combat “the overreaching, intrusive nature of Obamacare.” One Jan. 24, 2018, the Idaho Department of Insurance issued guidelines for the sale of insurance policies that fall short of ACA coverage requirements.

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According to the Associated Press, the Oregon House of Representatives passed a joint resolution stating that residents of the state have a fundamental right to healthcare. If the Oregon Senate also passes the bill, voters will be asked to consider amending the state constitution to declare: “It is the obligation of the state to ensure that every resident of Oregon has access to cost-effective, medically appropriate, and affordable healthcare as a fundamental right.”

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Read the press release (PDF)…


VTDigger reports that the Vermont Department of Health is considering eliminating a loan repayment fund designed to help rural communities attract healthcare providers. Under the program, certain providers, including primary care physicians, physician assistants, and nurses, receive an annual stipend to repay educational debt in exchange for a 12-month commitment to a Vermont practice. The department commissioner states that the fund has not produced the desired effect. Observers state that eliminating the program would save $667,000 in state and federal funding.

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Call for volunteers: Program Committees

March 30, 2018, is the last day to submit your application for a position on an AAOS program committee. Members of program committees grade symposia in May and abstracts in June and July and may serve as moderators for paper sessions at the AAOS Annual Meeting. The following openings are available:

  • Hand & Wrist (one member)
  • Practice Management/Rehabilitation (one member)

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

Learn more and submit your application…


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