President nominates Alex Azar as next HHS secretary
President Donald J. Trump named Alex M. Azar to be the next secretary of the U.S. Department of Health and Human Services (HHS). Mr. Azar formerly served as deputy secretary of HHS under President George W. Bush and spent 5 years as president of Lilly USA, LLC—an affiliate of drug manufacturer Eli Lilly and Company. Mr. Azar must undergo confirmation by the U.S. Senate before taking the position of secretary.
Study: Topical antibiotics may help reduce risk of SSI after open pelvic and acetabulum fixation
A study published online in the Journal of Orthopaedic Trauma suggests that use of topical antibiotics may help reduce risk of surgical site infection (SSI) after open pelvic and acetabulum fixation without increased risk of renal impairment. Members of the research team conducted a retrospective, cohort study of 140 patients with pelvic and acetabular fractures and who underwent open reduction and internal fixation at a single center, 71 of whom received 1.0 g vancomycin and 1.2 g tobramycin powder applied deep in the surgical wound and 69 control patients. They found that infection occurred in 4.2 percent of patients in the experimental cohort and 14.5 percent of patients in the control cohort but noted no difference between cohorts in renal function on postoperative day 2.
Study: Does FFS reimbursement affect treatment choices?
Data from a study published online in the journal Clinical Orthopaedics and Related Research suggest that a fee-for-service (FFS) reimbursement system may encourage practitioners to engage in more costly or invasive procedures compared to a non-FFS system. The researchers reviewed information on 28,344 patients who were surgically treated for lumbar disc herniation, spinal stenosis, or spondylolisthesis, 21,290 of whom were treated in an FFS environment and 7,054 of whom were treated in U.S. Department of Defense facilities. They found that patients treated for disc herniation or spinal stenosis in an FFS setting were more likely to receive interbody fusion, but they found no difference in likelihood of interbody fusion across cohorts for patients with a diagnosis of spondylolisthesis
AMA offers FAQ document to help employed physicians navigate QPP
The American Medical Association (AMA) released a guide designed to help hospital-employed physicians participate in the Medicare Quality Payment Program (QPP) created under the Medicare Access and CHIP Reauthorization Act (MACRA). The document includes a list of frequently asked questions (FAQs) and addresses topics such as compensation-related implications and use of electronic health records. Other topics include:
Comparison between employment and private practice
Study: Could readmissions reduction initiatives be linked to increase in mortality?
Findings from a study published online in the journal JAMA Cardiology suggest that implementation of the Medicare Hospital Readmissions Reduction Program (HRRP) may in some instances be linked to an increase in 30-day and 1-year mortality. The authors reviewed data on 115,245 hospitalizations for index heart failure across 416 U.S. hospital sites. They found that 30-day risk-adjusted readmission rate declined from 20 percent prior to HRRP implementation to 18.4 percent during the HRRP penalties phase. However, during the same period, 30-day risk-adjusted mortality rate increased from 7.2 to 8.6 percent, and 1-year risk-adjusted mortality rate increased from 31.3 to 36.3 percent.
An article in The New York Times reviews new regulatory changes that reduce the number and scope of Medicare mandatory payment programs, such as the Comprehensive Care for Joint Replacement (CJR) model. The writers note that the Trump administration recently released an outline for a “new direction” for the U.S. Center for Medicare & Medicaid Innovation (CMMI), which was set up under the Affordable Care Act to test models aimed at improving medical care and reducing costs. “While the Obama administration had pushed large, mandatory experiments to test new models of pay,” the writers state, “the Trump administration wants to encourage smaller, voluntary programs and asked the doctors to help design them.”
The American Association of Orthopaedic Surgeons (AAOS) plans to offer comments in response to an HHS request for information on this subject.
Your AAOS
Call for volunteers: Medicare Evidence Development & Coverage Advisory Committee
AAOS seeks to nominate members to the Medicare Evidence Development & Coverage Advisory Committee (MEDCAC). MEDCAC reviews and evaluates medical literature and technology assessments, hears public testimony on the impact of medical items and services on health outcomes of Medicare beneficiaries, and may advise the U.S. Centers for Medicare & Medicaid Services as part of the Medicare “coverage with evidence development” initiative. Applicants for this position must be active fellows, candidate members, candidate members osteopathic, candidate member applicants for fellowship, or candidate member applicants for fellowship osteopathic. In addition, all applicants must provide the following: an online AAOS CAP application, a current curriculum vitae (see description for required information), a 100-word biography, and a letter of interest highlighting his or her expertise in the subject area. All supporting materials must be submitted to Kyle Trivedi by Sunday, Nov. 19, 2017 at 11:59 p.m. CT, at:
