Today’s Top Story

Hospital consolidation linked to increase in healthcare pricing

According to a report from the nonprofit Health Care Pricing Project, hospital consolidation is often linked to an increase in healthcare pricing, while concentrated insurance markets are associated with lower prices and increased provider risk. The authors reviewed insurance claims data covering 28 percent of individuals with employer-sponsored health insurance in the United States. They found that healthcare spending per privately insured beneficiary differed by a factor of three across geographic areas, with a very low correlation to Medicare spending. In addition, hospital market structure was strongly associated with price levels and contract structure, with prices at monopoly hospitals 12 percent higher on average compared to those in markets with four or more competing institutions. Further, based on a review of 366 mergers and acquisitions from 2007 to 2011, the authors found that prices increased by more than 6 percent when the merging hospitals were geographically close (within 5 miles), but not when the hospitals were geographically distant (more than 25 miles apart).

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Other News

Study: What happens after surgical repair of acetabular fracture?

A study conducted in the Netherlands and published online in The Bone & Joint Journal looks at outcome trends following surgical repair of acetabular fracture. The researchers reviewed data on 220 patients who underwent surgery for an acetabular fracture at a single center At mean six-year follow-up, they found that 55 (25 percent) had developed post-traumatic osteoarthritis (OA) and 33 (15 percent) had undergone total hip arthroplasty (THA) at mean 2.75 years. Based on 164 patients who completed both the 36-Item Short Form Health Survey and the modified Harris Hip Score questionnaires, the researchers state that patients who underwent THA had worse functional outcomes compared to those who retained their native hip joint.

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Study: Gout may not be linked to increased risk of fracture

Information from a study conducted in the United Kingdom and published in the May 14 issue of the Canadian Medical Association Journal suggests that gout may not be associated with an increased risk of fracture. Members of the research team reviewed data on 31,781 patients with incident gout and 122,961 control participants from the Clinical Practice Research Datalink. They found that the absolute rate of fracture was similar for both cases and controls, and corresponded to a hazard ratio of 0.97. The researchers state that the finding remained unchanged even when the analysis was stratified by age and sex.

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Survey: Can public “physician report cards” affect clinical decision-making?

A report published online in JAMA Cardiology notes a potential link between specialist attitudes toward public reporting requirements and clinical decision-making. The authors surveyed 149 interventional cardiologists regarding avoidance of a common interventional procedure in a high-risk patient population. They found that 65 percent of respondents said they had avoided administering a procedure on at least two occasions due to concern that a poor outcome could negatively affect their public reports.

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Study: Alendronate may reduce the risk of cardiovascular conditions

The osteoporosis drug alendronate may reduce the risk of cardiovascular death, heart attack, and stroke, according to a study published online in the Journal of Bone and Mineral Research. For this retrospective, cohort study, researchers used a population-wide database managed by the Hong Kong Hospital Authority to identify 4,594 patients with newly diagnosed hip fracture who received an anti-osteoporosis medication between 2005 and 2013, along with a matched control cohort of 13,568 patients. They found that patients who received alendronate had significantly lower risk of one-year cardiovascular mortality and incident myocardial infarction. The drug was also associated with a marginally significant reduction in the risk of stroke at five and 10 years. The strength of the association declined over time but remained significant, the researchers noted.

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CMS issues rule to help maintain access to DME in remote areas

The U.S. Centers for Medicare & Medicaid Services (CMS) has issued an interim final rule with comment period to increase the fee schedule rates from June 1, 2018, through December 31, 2018, for certain durable medical equipment (DME) items and services in rural and noncontiguous areas such as Alaska, Hawaii, and U.S. territories that are not subject to the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies Competitive Bidding Program. The agency states that some stakeholders have voiced concerns regarding significant financial challenges that current adjusted DME fee schedule rates may pose for suppliers, and that the number of suppliers in certain areas of the country continues to decline.

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Your AAOS

Still time to help transitioning veterans as part of AAOS/ACP mentoring initiative

AAOS has partnered with American Corporate Partners (ACP), a national, nonprofit organization dedicated to helping military service members transition to the private sector through one-on-one mentoring with business leaders. ACP mentors and protégés are paired for one year based on a variety of considerations including age, location, educational background, and shared career interests. Each pair is encouraged to speak at least once a month to discuss topics like résumé and interview preparation, networking, and other professional development topics. To sign up as an AAOS/ACP mentor, visit the link below and enter the access code “AAOSACP” when prompted.

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