February 2, 2018
Today’s Top Story

CMS proposes percent increase in baseline MA pay rates; opioid limits

The U.S. Centers for Medicare & Medicaid Services (CMS) has proposed an average 1.84 percent increase in baseline Medicare Advantage (MA) payment rates for 2019. Modern Healthcare reports that, after taking into account the way health plans code diagnoses, the average Medicare Advantage payment rate will effectively increase by 3.1 percent. In the same announcement, CMS proposed “hard formulary levels” at pharmacies to restrict the amount of opioids that Medicare beneficiaries can receive. The agency also plans to increase the use of encounter data to determine risk scores, despite concerns of some healthcare stakeholders, including the American Hospital Association, that such data may lack accuracy.

Read more about MA pay rates…  (registration may be required)

Read more about the opioid limits…

Read the CMS statement (PDF)…

Other News

Study: Age and ASA status may help identify risk of adverse outcomes after PLF

A study published in the January issue of The Spine Journal suggests that American Society of Anesthesiologists (ASA) physical status classification and patient age may help identify risk of perioperative adverse outcomes following posterior lumbar fusion (PLF) as well as other, more difficult to implement indices. The authors reviewed prospectively collected data on 16,495 patients who underwent elective PLF and compared the discriminative ability of ASA, modified Charlson Comorbidity Index, and modified Frailty Index, as well as demographic factors including age, body mass index, and gender for perioperative adverse outcomes following PLF. They found that the most predictive comorbidity index was ASA and the most predictive demographic factor was age. Of those, age was most discriminative for three out of six adverse outcomes and ASA was the most predictive for one out of six adverse outcomes. The authors write that the combination of ASA and age “resulted in improvements in discriminative ability over the individual components for five of the six outcome variables”

Read the abstract…

Study: DTA reconstruction and Latarjet may offer similar outcomes for recurrent anterior shoulder instability

According to a study published online in The American Journal of Sports Medicine, fresh distal tibia allograft (DTA) reconstruction and the Latarjet procedure may offer similar outcomes for recurrent anterior shoulder instability. The researchers conducted a prospective, matched cohort study of 100 patients who underwent shoulder stabilization, 50 of whom were treated with DTA and 50 of whom were treated with Latarjet. At minimum 2-year follow-up (range 24 to 111 months), they found that patients in both cohorts experienced significant improvement in all outcome scores after surgery. The researchers found no significant differences across cohort in postoperative visual analog scale, American Shoulder and Elbow Surgeons, Western Ontario Shoulder Instability Index, or Single Assessment Numeric Evaluation scores. They note, however, that patients in the Latarjet group had superior Simple Shoulder Test outcomes. There were five complications, 3 of which required reoperation, in each cohort.

Read the abstract…

Providers have “unprecedented opportunity” to respond to signs of abuse

An article in Kaiser Health News discusses how providers can respond when confronted with signs of possible physical abuse. “Nearly 1 in 4 women have experienced serious physical violence at the hands of a partner,” the writer notes. Such patients may not volunteer the reason for their injuries, and many physicians don’t ask about abuse in the home. A spokesperson of the organization Futures Without Violence notes that physicians offer an excellent channel to prevent and respond to abuse “because they are seeing patients that may not ever reach out to a domestic violence agency or police for help.” The U.S. Preventive Services Task Force (USPSTF) concluded in 2013 that the intervention of healthcare providers could reduce violence and abuse as well as mental and physical health problems.

Read more…

Read more about intimate partner violence from USPSTF…

In the States

Nebraska

Healthcare IT News reports that Nebraska has become the first state to require reporting of all dispensed prescription drugs to the Prescription Drug Monitoring Program (PDMP). A spokesperson for the Nebraska Health Information Initiative said the move is intended to save lives, not only for patients taking opioids, but potentially for anyone prescribed drugs. A national PDMP initiative took effect Jan. 1, 2018.

Read more…

Washington

A report from the nonprofit Washington Health Alliance projects that more than 600,000 patients in Washington state may have received a treatment considered by the medical community to be low value in the period July 2015 to June 2016. The researchers reviewed patient records for 47 common treatment approaches known designated as low value by the nationwide Choosing Wisely initiative. They found that approximately 1.3 million individuals received one of those 47 services, and among those, 47.9 percent received a low-value service. Overall, they project that 36 percent of spending on the healthcare services examined went to low-value treatments and procedures.

Read the report (PDF)…

Learn more about Choosing Wisely…

Your AAOS

Apply now for the 2018 AAOS/OREF/ORS Clinician Scholar Career Development Program

March 31, 2018, is the last day to submit an application to participate in the 2018 AAOS/Orthopaedic Research and Education Foundation (OREF)/Orthopaedic Research Society (ORS) Clinician Scholar Career Development Program (CSCDP). CSCDP is an annual workshop that seeks applicants in years PGY-2 to PGY-5 of orthopaedic residency, fellows, and junior faculty through year 3 who have the potential and desire to become orthopaedic clinician scientists Up to 15 AAOS-sponsored participants will be selected to participate in the 1.5-day CSCDP career training program. The 2018 CSCDP will be held Sept. 27–29, 2018, in Rosemont, Ill.

Learn more and submit your application…

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