oday’s Top Story
Study: HA often used for treatment of knee OA, despite evidence against efficacy.
A study published in the Sept. 7 issue of The Journal of Bone & Joint Surgery (JBJS) finds that hyaluronic acid (HA) injections continue to be used to treat knee osteoarthritis (OA), despite studies questioning its efficacy and cost-effectiveness and an AAOS clinical practice guideline (CPG) recommendation against it. The researchers reviewed information on 244,059 patients who underwent total knee arthroplasty (TKA) from 2005 to 2012. Of those, 35,935 (14.7 percent) had at least one HA injection in the 12 months preceding TKA. They note that HA injections were responsible for 16.4 percent of all knee OA-related payments, and that HA injections accounted for 25.2 percent of treatment-specific payments—a rate higher than that of any other treatment.
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View the AAOS CPG…
Other News
Study: TAA linked to lower rates of readmission and infection compared to ankle arthrodesis.
A study published in the Sept. 7 JBJS suggests lower complication rates for total ankle arthroplasty (TAA) compared to primary ankle arthrodesis. The authors reviewed a state database of hospital discharges and identified 8,491 ankle arthrodesis procedures and 1,280 TAAs. They found that short-term complication risk was low for both procedures, but that patients who received TAA had significantly lower rates of readmission and periprosthetic infection compared with patients who had ankle arthrodesis. Overall, TAA patients were more likely to be female, white, and older, and to have Medicare or private health insurance compared to fusion patients.
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Does CMS expect too much from ACOs?
An article in The New York Times looks at the issue of accountable care organizations (ACOs) under U.S. Centers for Medicare & Medicaid Services (CMS) rules. The writer notes that CMS has encouraged providers to form ACOs based on a model devised by researchers at Dartmouth College. However, Dartmouth itself has dropped out of the federal ACO program, citing financial losses. An evaluation of the Dartmouth ACO found that it had reduced Medicare spending on hospital stays, medical procedures, imaging, and tests, and achieved quality goals. However, the ACO failed to meet money-saving benchmarks set by federal officials and was subject to financial penalties.
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CMS rule will require certain providers to address emergency preparedness.
CMS has finalized a rule to establish consistent emergency preparedness requirements for healthcare providers who participate in Medicare and Medicaid. A CMS review found that current regulatory requirements do not address certain areas of emergency preparedness, including the need for communications, contingency planning, and personnel training. The new rule requires certain participating providers and suppliers to coordinate with emergency preparedness systems to ensure that facilities are adequately prepared to meet the needs of their patients during disasters and emergency situations.
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Read the CMS statement…
Read the rule…
Vermont.
An article on VTDigger.com (a project of the Vermont Journalism Trust) profiles regulatory issues faced by an ambulatory surgery center (ASC) that some argue would negatively affect existing hospital systems. Supporters of the ASC say that, if approved, it would reduce wait times and reduce costs. Critics charge that the proposed project would be an “unregulated” ASC “without any obligations to the Vermont community,” and that allowing the project to proceed would have a “direct negative impact” on hospital finances, access to health services, healthcare costs, and healthcare reform.
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Wisconsin.
The Wisconsin State Journal reports that the Wisconsin Injured Patients and Families Compensation Fund, which was formed in 1975 to insure healthcare providers facing large medical liability awards, has seen a significant reduction in payments to injured patients in recent years. As a result, it has an $813 million surplus, more than twice the amount that regulators recommend.
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Submit your entries now! MORE Awards honor excellence in orthopaedic journalism.
The Media Orthopaedic Reporting Excellence (MORE) Awards recognizes and honors journalistic efforts that further the public’s understanding of musculoskeletal health issues and encourage healthy behaviors in the care of bones and joints. AAOS is asking members to submit stories from broadcast, radio, print, or websites that accurately and compassionately highlight orthopaedic procedures, treatments, and preventive care and practices. Stories must have been published or broadcast between Oct. 1, 2015, and Oct. 1, 2016. Winners will be recognized at the 2017 MORE Awards ceremony and dinner during the National Orthopaedic Leadership Conference in Washington, D.C., on April 27, 2017. For more information, please contact Kelly King Johnson at 847-384-4033.
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media@aaos.org
