December 15, 2017 | Today’s News

Study: Infection may be most common reason for medical liability suits following TJA

Findings from a study published online in The Journal of Arthroplasty suggest that infection may be the most common reason for litigation following total joint arthroplasty (TJA). The researchers conducted a retrospective review of lawsuits filed in a five-county metropolitan area between 2009 and 2015. They found that 83 lawsuits were filed, 50 of which were dismissed or settled out of court, and 31 of 113 surgeons were named as a defendant in at least one suit. In descending order, the most common reasons for litigation were infection, nerve injury, chronic pain, vascular injury, periprosthetic fracture, retention of foreign body, dislocation, limb-length discrepancy, venous thromboembolism, loosening, compartment syndrome, and other medical complaints.

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Still time for Medicare providers to meet minimal reporting requirements and avoid 2019 payment penalty

Healthcare IT News is reminding providers that they need only report on one quality measure for one patient during 2017 in order to avoid a Medicare payment penalty in 2019. Providers that submit 90 days of 2017 data to Medicare may earn a neutral or small positive payment adjustment during 2019 under the Merit-based Incentive-Payment System (MIPS) track of the Medicare Access and CHIP Reauthorization Act (MACRA). However, practices can begin data collection as late as Dec. 31, 2017, to submit a minimum amount of data and still avoid a payment penalty in 2019. In 2019, the U.S. Centers for Medicare & Medicaid Services will cut Medicare pay 4 percent for providers who do not submit any 2017 MIPS data.

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The American Medical Association (AMA) has published a video with step-by-step instructions on reporting.

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Learn more about MIPS…

Visit the AAOS MACRA and Delivery Reform page…

A report from the Kaiser Family Foundation projects that 16 states will run out of federal funding for the Children’s Health Insurance Program (CHIP) by the end of January, and lacking action by the U.S. Congress, up to three-quarters of all states will exhaust their funding by the end of March 2018 According to the report, states that are not required to maintain separate CHIP coverage may discontinue coverage or transition enrollees to Medicaid. Some states have state laws that require them to close the program or discontinue coverage if federal funds decrease. States that are required to maintain CHIP-funded Medicaid expansion coverage may face budget shortfalls, as nearly all states assumed continued federal CHIP funding in their FY 2018 state budgets.

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A study published in the January issue of The Journal of Arthroplasty suggests that patient selection is an important factor for maintaining patient safety for TJA performed in an ambulatory surgery center (ASC). The authors reviewed charts of 3,444 TJA patients and assigned ASC eligibility based on American Society of Anesthesiologists (ASA) status, exclusion criteria, and existing comorbidities. They found that 70.3 percent of all patients were eligible for TJA performed in an ASC. Among ASA class 3 patients who did not meet any exclusion criteria but had systemic disease, the researchers deemed 53.69 percent ASC-eligible due to sufficiently low severity of comorbidities. The most frequent reasons for ineligibility were body mass index >40 kg/m ², severity of comorbidities, and untreated obstructive sleep apnea.

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A study published online in the journal Foot & Ankle International examines outcomes for surgical correction of acquired deformity associated with midtarsal Charcot foot arthropathy. Members of the research team conducted a retrospective, case series study of 214 patients (9 bilateral) who underwent deformity reconstruction. Overall, they found that 173 of 223 feet (77.6 percent) achieved a favorable clinical outcome, defined as ability to walk with commercially available prescription footwear. The researchers also identified three patterns of deformity, based on weight-bearing pattern, relationship of the forefoot to the hindfoot, and integrity of the talocalcaneal joint. They note that 138 feet displayed a valgus deformity pattern, 48 feet displayed a varus deformity pattern, and 37 feet displayed dislocation of the talocalcaneal joint. Further, the researchers found that 87 percent of patients with a valgus pattern, 70.3 percent of those with a dislocation pattern, and 56.3 percent of those with a varus pattern achieved a favorable clinical outcome.

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An article in Modern Healthcare looks at the potential impact on health care of repealing net neutrality. The U.S. Federal Communications Commission voted to repeal net neutrality rules, which prevent internet service providers from preferentially throttling or enhancing consumer access to certain internet sites. Observers say the move could negatively affect telemedicine, unless future rules carve out exceptions to prevent such services from being throttled. In a separate vote, FCC approved a proposal to increase funding to the Rural Health Care Program to help rural providers modernize their communications services.

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Read the FCC statement (PDF)…

Call for volunteers: PCORI physician specialty society roundtable

AAOS seeks to nominate one member to participate in the upcoming physician roundtable hosted by the Patient-Centered Outcomes Research Institute (PCORI). The discussion will offer an opportunity for PCORI to share its progress and identify new ways the organization can collaborate with physician specialty societies, particularly regarding dissemination and implementation of PCORI-funded evidence into physician practice. 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 with either spine or total joint expertise. In addition, all applicants must provide the following: an online AAOS CAP application, a current curriculum vitae, and a 100-word biography. All supporting materials must be submitted to Kyle Trivedi by Dec. 17, 2017, at 11:59 p.m. CT, at:

trivedi@aaos.org

Learn more and submit your application…  (member login required)