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| Today’s Top Story
CMS releases three rules affecting physicians
The U.S. Centers for Medicare & Medicaid Services (CMS) recently released three rules that may affect physician reimbursement in 2018. The first rule proposes updates to payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule on or after Jan. 1, 2018. Among other things, it includes a 0.41 percent increase in Medicare reimbursement, based on a 0.50 percent update established under the Medicare Access and CHIP Reauthorization Act, reduced by 0.09 percent called for under the Achieving a Better Life Experience Act.
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The second rule updates the Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System. Among other things, the rule removes total knee arthroplasty (TKA) from the Medicare inpatient-only list and removes three Ambulatory Surgical Center Quality Reporting Program quality measures and six Hospital Outpatient Quality Reporting Program quality measures for 2019.
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The American Association of Orthopaedic Surgeons (AAOS) issued a statement in response to this rule, applauding CMS for noting that “the surgeons, clinical staff, and medical specialty societies that perform outpatient TKA and possess specialized clinical knowledge and experience” are most suited to create guidelines to identify appropriate candidates for outpatient TKA procedures.
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The third rule, among other things, reduces the number of clinicians required to participate in the CMS Quality Payment Program and finalizes flexibilities for small and solo practitioners.
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| Other News
U.S. House passes IPAB repeal
The U.S. House of Representatives passed a bill to repeal the Medicare Independent Payment Advisory Board (IPAB)—a panel called for under the Affordable Care Act (ACA) that has the authority to propose cuts to Medicare if spending growth exceeds certain levels. The IPAB repeal bill passed with bipartisan support, 307-11.
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| U.S. House passes CHIP funding bill
The U.S. House of Representatives passed a bill to reauthorize federal funding to maintain the Children’s Health Insurance Program (CHIP). CHIP funding officially expired in October, but most states had enough available funds to continue the program for a short time. The CHIP bill passed largely on party lines; some Democrats have opposed the bill because it would increase Medicare premiums to seniors who earn more than $500,000, shorten the grace period for people who don’t pay ACA marketplace premiums from 90 days to 30 days, and redirect money from the ACA prevention and public health fund to community health centers.
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| Study: How does PNB compare with PAI as part of a multimodal analgesia pathway for THA patients?
A study published in the Nov. 1 issue of The Journal of Bone & Joint Surgery compares the use of peripheral nerve blockade (PNB) against two variations of periarticular infiltration (PAI) as part of a multimodal analgesia pathway for total hip arthroplasty (THA). The authors conducted a randomized clinical trial of 159 patients who underwent THA and who received either PNB (n = 51), PAI with ropivacaine, ketorolac, and epinephrine (PAI-R; n = 54), or PAI with liposomal bupivacaine, ketorolac, and epinephrine (PAI-L; n = 54). They found that opioid consumption was low and did not differ across cohorts at any time interval. However, based on a 1-10 ascending numeric rating scale, median maximum pain on postoperative day 1 was 5.0 in the PNB group, 5.5 in the PAI-R group, and 4.0 in the PAI-L. On postoperative day 2, median maximum pain was 3.5 for the PNB group, 5.0 for the PAI-R group, and 3.5 for the PAI-L group. The authors write that the PAI-L group was not significantly different from the PNB group with respect to any outcomes: postoperative opioid use, length of stay, hospital adverse events, and 3-month follow-up data including any complication.
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| Study: Exercise intervention may help reduce elbow injuries in young baseball players
Data from a study published online in The American Journal of Sports Medicine suggest that use of an exercise program to improve physical function can help reduce the likelihood of medial elbow injury in youth baseball players. The researchers conducted a cohort study of 305 baseball players, aged 8 to 11 years, with no history of elbow or shoulder pain. Overall, 136 were assigned to an intervention cohort and 169 received no intervention. Intervention consisted of nine strengthening and nine stretching exercises, performed during warm-up or at home, with high compliance defined as completion of the program one or more times per week. At 1-year follow-up, the researchers found that the incidence rate of medial elbow injury was significantly lower in the intervention group compared to the control group. In addition, the intervention program was associated with improved total range of shoulder rotation (dominant side), hip internal rotation (nondominant side), shoulder internal rotation deficit (bilaterally), lower trapezius muscle strength (dominant side), and the thoracic kyphosis angle.
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| Your AAOS
AJRR releases annual report based on hip and knee arthroplasty data
The American Joint Replacement Registry (AJRR) released its fourth annual report on hip and knee arthroplasty data. The 2017 Annual Report analyzes data on 860,080 hip and knee arthroplasties performed by 4,755 surgeons across 654 institutions. In addition to broad information on overall trends, the report analyzes primary and revision hip and knee procedural data. Additional information is provided on AJRR collaborative projects, yearly data audit, 2017 accomplishments, and future areas of study.
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| Call for abstracts: 2018 EWI research symposium
AAOS seeks abstracts for combat casualty and trauma-related research for poster presentations at the 2018 AAOS/OTA/SOMOS/ORS Extremity War Injuries (EWI) symposium, to be held Jan. 21-23, 2018, in Washington, D.C. Up to 20 abstracts will be selected for poster presentations. If an abstract is accepted for exhibition, the poster will be displayed Jan. 22 and 23, with a dedicated poster session from 6 to 7 p.m. on Monday, Jan. 22, 2018. Authors must be present to participate in the poster session. In addition, select authors will be invited to give a brief podium presentation during the symposium. The $600 EWI registration fee is waived for poster presenters. Presenters are responsible for hotel and travel costs associated with attending the EWI symposium. Abstracts must be submitted by Nov. 10, 2017.
Learn more and submit your abstract… |
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