Today’s Top Story

MIPS reporting deadline is less than two weeks away

The California Medical Association has issued a reminder that the March 31, 2018, deadline to submit 2017 data for the Medicare Merit-based Incentive Payment System (MIPS) is just two weeks away. The organization notes that the group reporting deadline has passed, but the deadline for all other MIPS reporting is less than two weeks away. Providers who are unsure of their MIPS reporting status should enter their National Provider Identifier in the MIPS Lookup Tool.

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Verify MIPS participation status…


An article in Health Affairs notes that the Medicare Payment Advisory Commission (MedPAC) recently recommended that the U.S. Congress eliminate MIPS and adopt an alternative approach for promoting high-quality clinician care for beneficiaries in traditional Medicare.

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Read the MedPAC report to Congress (PDF)…

Other News

Physician salary survey finds that women earn less than men in every specialty

A survey conducted by Doximity tracks physician reimbursement information and, among other things, identifies an average 4 percent wage increase across the United States from 2016 to 2017. In this survey, orthopaedic surgeons ranked third of all specialties, with an average $537,568 in reimbursement The survey also notes that across all specialties male physicians earn more than female physicians, with a 28 percent salary disparity in 2017—an increase from a 26.5 percent disparity in 2016. On average, female orthopaedic surgeons earn 19 percent less than their male counterparts or $101,291 less per year.

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Study: Bracing or no bracing may not affect functional outcome after ORIF of tibial plateau fracture

Data from a study published March 15, 2018, in the Journal of the AAOS suggest no difference in functional outcomes whether patients are braced or not braced following open reduction and internal fixation (ORIF) of tibial plateau fracture. The authors conducted a prospective, comparative trial of 49 patients, 24 of whom were treated with bracing after ORIF and 25 of whom were not. They found no significant difference in most functional, subjective, and radiographic outcomes, including fracture characteristics, complications, postoperative range of motion, Medical Outcomes Study 36-Item Short Form scores, and union rates. The authors write that one patient in the nonbraced cohort had late joint collapse with valgus malalignment. In addition, two wound complications occurred in the braced group and four wound complications occurred in the nonbraced group, but the difference was not statistically significant.

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Study: Incidence of most THA complications fell over time

A study conducted in the United Kingdom and published in the March 7 issue of The Journal of Bone & Joint Surgery examines complication trends following total hip arthroplasty (THA). The researchers reviewed data on 540,623 THAs performed between January 2005 and July 2014. They found that the overall 90-day mortality rate fell over the term of the study from 0.60 percent to 0.15 percent, and reported postoperative complications (with the exception of lower respiratory tract infection and renal failure) fell each year, despite a steady increase in the average Charlson Comorbidity Index score. However, the researchers state that the 30-day rate of lower respiratory tract infection increased from 0.54 percent to 0.84 percent and the 30-day rate of renal failure increased from 0.21 percent to 1.09 percent. They note that the observed risk of mortality was significantly higher for those two conditions than for patients who developed pulmonary embolism or deep-vein thrombosis.

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CMS Hospital Star Ratings indicate better quality for specialty hospitals

An analysis from Modern Healthcare suggests that the most recent version of the U.S Centers for Medicare & Medicaid Services (CMS) Star Rating formula rates specialty hospitals better than major teaching hospitals. The agency recently modified its Star Rating system to increase accuracy and fairness. A study of recent CMS data finds that of 74 specialty hospitals that received a star rating in December 2017, 45 (61 percent) received a five-star rating and 16 (22 percent) received a four-star rating. At the same time, of 172 major teaching hospitals that received a star rating, 15 (9 percent) received a five-star rating and 25 (15 percent) received four stars. Several hospital associations have criticized the CMS Star Rating system in the past, arguing that it unfairly penalizes teaching hospitals and institutions that serve large, underprivileged populations.

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Improved patient education may reduce unnecessary procedures and expenditures

An opinion piece published in the March 13 issue of The Journal of the American Medical Association calls hip and knee arthroplasty procedures “necessary and life changing” for many patients. However, the writers note that rates of such procedures are much higher in the United States than in other developed countries and point to studies that suggest some joint arthroplasty procedures may be inappropriate for the patient. “Patients often opt for elective procedures based on their high expectations of positive outcomes, undervaluing of potential harms, and lack of knowledge about alternative treatments,” they write. The writers note that presurgery patient education materials may focus on procedural details and aftercare instead of informed decision making. “Educating patients about alternatives and risks can support decision making by patients and physicians,” they continue. “Well-developed decision aids can delay elective procedures until they are appropriate, avoiding unnecessary and more costly revision procedures.”

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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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