September 25, 2017

Today’s Top Story
CMS Innovation Center to refocus on increased payment model flexibility.
In a letter to The Wall Street Journal, the administrator of the U.S. Centers for Medicare & Medicaid Services (CMS) states that the agency is redesigning the CMS Innovation Center to offer providers increased payment model flexibility and encourage greater competition among healthcare systems. She notes that current models have encouraged consolidation and states that the Innovation Center is addressing eight focus areas, including:

  • Increasing participation in advanced alternative payment models
  • Consumer-directed care and market-based innovation
  • Physician specialty models
  • State-based and local innovation, including Medicaid focused models
  • Program integrity

CMS has issued a request for information (RFI) regarding the new direction. The American Association of Orthopaedic Surgeons (AAOS) plans to plans to respond. Read the CMS RFI (PDF)…
Read the letter…(paid subscription required)
Read more in Healthcare IT News

Other News

Are there too many delays in FDA postmarketing studies of approved drugs?
As reported in Reuters, a perspective piece in the Sept. 21 issue of The New England Journal of Medicine raises concerns regarding the status of postmarketing studies of U.S. Food and Drug Administration (FDA)-approved drugs. Researchers reviewed federal records and found that of 614 postmarketing studies mandated by FDA during 2009 and 2010, 20 percent were never started and 9 percent were delayed. However, a response from FDA representatives states that as of 2015, 88 percent of postmarketing requirements overall and 89 percent of postmarketing requirements under the FDA Amendments Act of 2007 were on time based on their original schedules. Read more…
Read the abstract…(paid subscription required)
Read the FDA response…

Study: Longer shoulder arthroscopy procedure time associated with increased risk of adverse short-term outcomes.
According to a study published online in the journal Arthroscopy, increased shoulder arthroscopy procedure time may be associated with increased likelihood of adverse short-term outcomes. Members of the research team conducted a retrospective, cohort study of 33,095 shoulder arthroscopy procedures, of which 7,027 (21.2 percent) were shorter than 45 minutes, 16,610 (50.2 percent) were between 45 and 90 minutes, and 9,458 (28.6 percent) were longer than 90 minutes. Compared to procedures of less than 45 minutes, they found increased risk of superficial surgical site infection (SSI) and overnight stay for procedures lasting between 45 and 90 minutes and for procedures of longer than 90 minutes. In addition, the research team notes that body mass index >30 kg/m2 was an independent predictor of both overnight hospital stay and superficial SSI, while age >60, female sex, American Society of Anesthesiologists class ≥3, and a history of diabetes mellitus, hypertension, or chronic obstructive pulmonary disease were additional predictors of overnight hospital stay. Read the abstract…

Study: Outcomes for surgical treatment of hip fracture not linked to surgeon or hospital volume.
Data from a study published in the Sept. 20 issue of The Journal of Bone & Joint Surgery suggest that hip fracture surgical outcomes may not be significantly affected by surgeon or hospital volume. The authors reviewed information on 14,294 patients from a single, large, integrated healthcare system. They found no significant association between surgeon or hospital volume and mortality at 30 days, 90 days, or 1 year, and also no association between surgeon or hospital volume and reoperation, medical complications, or unplanned readmission. The authors state that the data do not suggest that hip fractures be preferentially directed toward high-volume surgeons or hospitals for treatment. Read the abstract…

Study: Protein signal may be linked to osteoporosis.
Findings from a mouse study published in the Sept. 19 issue of Proceedings of the National Academy of Sciences suggest that the Cbfβ protein may govern osteoblast-adipocyte lineage commitment and may be a therapeutic target for osteoporosis. Members of the research team generated three mouse models by deleting Cbfβ at different osteoblast lineage stages. They found that all three mouse models exhibited severe osteoporosis, “with substantial accumulation of marrow adipocytes resembling aged bone from enhanced adipogenesis, indicating that mesenchymal stem cells and osteoblasts can be programed and reprogramed, respectively, into adipocytes.” Read more…
Read the abstract…

Report: Antibiotic development pipeline might not keep up with growing antimicrobial resistance.
A report from the World Health Organization (WHO) analyzes the antibacterial clinical development pipeline and suggests a serious lack of new antibiotics under development to combat the growing threat of antimicrobial resistance. The reports notes that most of the drugs currently in the clinical pipeline are modifications of existing classes of antibiotics and may only serve as short-term solutions. In addition, the writers found few potential treatment options for antibiotic-resistant infections identified by WHO as posing the greatest threat to health. Based on average success rates and development times, the writers state that the current pipeline of antibiotics and biologicals could lead to approximately 10 new approvals over the next 5 years. However, they state that the potential new treatments will not be sufficient to tackle impending threats of antimicrobial resistance. Read more…
Read the report (PDF)…

Last call: ACGME Residency Review Committee for Orthopaedic Surgery.
Sept. 30 is the last day to submit your application for a position on the Accreditation Council for Graduate Medical Education (ACGME) Review Committee for Orthopaedic Surgery. AAOS seeks to nominate two members to the committee. Nominees for this position must be active fellows and currently certified by the American Board of Orthopaedic Surgery in orthopaedic surgery and in at least one of the following orthopaedic surgery subspecialty areas: pediatrics or spine. Learn more and submit your application…(member login required)

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