Today’s Top Story
House passes legislation to repeal and replace the ACA.
In a 217-213 vote, the U.S. House of Representatives has passed the American Health Care Act (AHCA), which if enacted will repeal and replace the Affordable Care Act (ACA). The measure now moves to the U.S. Senate, where it is expected to undergo further revision.
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An article in Politico summarizes some key aspects of the AHCA…
The White House has posted a transcript of President Trump’s comments on the vote.
An article in The New York Times looks at some of the opposition to the bill.
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Other News
CDC releases guideline on SSI prevention.
The U.S. Centers for Disease Control and Prevention has released a guideline for the prevention of surgical site infection (SSI). Among other things, the guideline notes that infection is the most common indication for revision in total knee arthroplasty and the third most common indication in total hip arthroplasty. The guideline includes a section on prosthetic joint arthroplasty, covering topics such as blood transfusions, systemic immunosuppressive therapy, intra-articular corticosteroid injections, anticoagulation, orthopaedic surgical space suits, postoperative antimicrobial prophylaxis, and biofilms.
Read the guideline…
Study: ACL reconstruction may reduce length of NFL careers and affect player performance.
A study published online in The American Journal of Sports Medicine examines return to play issues among National Football League (NFL) players who undergo anterior cruciate ligament (ACL) reconstruction. The authors compared information on 38 defensive players who underwent ACL reconstruction—28 of whom returned to play at least one NFL game—against a group of matched controls. They found that 23 players successfully returned to play at least half a season (eight games). However, returning athletes in the ACL reconstruction cohort retired significantly sooner and more often after surgery than their matched controls. In addition, in seasons leading up to their injury, athletes who successfully returned to play started a greater percentage of their games and made more solo tackles per game compared with athletes in the ACL reconstruction group who did not return to play and compared with healthy control players. After the season of surgery, athletes in the ACL reconstruction group who returned to play decreased their number of games started and number of solo tackles per game, while their matched controls experienced no significant decreases.
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Study: Infant prescriptions of H2-blockers and PPIs linked to increased fracture risk.
According to a study to be presented at the annual meeting of the Pediatric Academic Societies, infants who are prescribed H2-blockers or proton pump inhibitors (PPIs) may be at increased risk of bone fracture later in childhood. The researchers reviewed data on 874,447 healthy children born within the Military Health System and who received care within the system for at least 2 years. They noted that about 10 percent of the children were prescribed antacids in the first year of life, including H2-blockers and PPIs, with a small percentage prescribed both. The researchers found that infant PPI prescriptions were associated with a 22 percent increased likelihood of fracture, while children prescribed both PPIs and H2-blockers had a 31 percent increased likelihood of fracture. The researchers state that use of H2-blockers alone was not associated with an immediate increase in fractures, but was linked to an increased likelihood of fracture with time.
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Study: Restrictions on sales rep visits linked to changes in prescribing.
Findings from a study published in the May 2 issue of The Journal of the American Medical Association suggest that policies restricting pharmaceutical representative sales visits at academic medical centers (AMCs) may be associated with modest but significant reductions in prescribing of certain drugs. The research team analyzed data on 16,121,483 prescriptions written between January 2006 and June 2012 by 2,126 attending physicians at 19 intervention group AMCs and by 24,593 matched control group physicians. They found that exposure to an AMC detailing policy was linked to a decrease in market share of detailed drugs of 1.67 percentage points and an increase in market share of nondetailed drugs of 0.84 percentage points. The research team notes that associations were statistically significant for six of eight study drug classes for detailed drugs: lipid-lowering drugs, gastroesophageal reflux disease drugs, antihypertensive drugs, sleep aids, attention-deficit/hyperactivity disorder drugs, and antidepressant drugs, and for nine of the 19 AMCs that implemented policies. Overall, 11 of 19 AMCs regulated salesperson gifts to physicians, restricted salesperson access to facilities, and incorporated explicit enforcement mechanisms, and among eight of those there was a significant change in prescribing, while there was a significant change in prescribing at only one of eight AMCs that did not enact policies in all three areas.
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Read the abstract…
Texas.
The Houston Chronicle reports that the Texas Legislature has passed a bill that, if enacted, will require freestanding emergency departments (EDs) and other out-of-network providers to enter into mediation with patients who dispute balance bills. In 2009, the state adopted a mediation process for unexpected balance bills arising from ED visits, but only 3,800 patients have sought mediation since the program’s introduction. A recent study by the Center for Public Policy Priorities found that more than 300 hospital emergency rooms in Texas do not have a single ED physician covered by the state’s three largest insurance plans.
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Read the bill…
May AAOS Now is online now and in your mailbox soon!
AAOS members will soon receive the print edition of the May issue of AAOS Now, but the online edition is already available on the AAOS Now website. This month’s issue includes a look at a plans by U.S. News & World Report to publish hip and knee surgeon ratings, a report from an AAOS Annual Meeting symposium on disparities in health care, an article on the future of orthopaedic practice, and much more!
Read more…(member login required)
Read “U.S. News & World Report to Publish Hip and Knee Surgeon Ratings”…
Read “Orthopaedic Surgeons and the Quality Conundrum”…
Read “The Future of Orthopaedic Practice in America”…
