September 24, 2018 | Today’s News

Study Analyzes Effect of Implant Orientation on Knee Implant Performance

A study published in the September issue of The Journal of Arthroplasty found that total knee arthroplasty (TKA) position and orientation may impact polyethylene damage and how the knee performs postoperation. Researchers compared three-dimensional CT measurements of prerevision TKA positioning with postrevision retrieval analysis for 30 TKA implants and calculated differences in thickness between medial and lateral components. Varus angulations were tied to thinner medial compartments, and valgus angulations were linked to thinner lateral compartments. Thickness varied among suboptimal tibial and tibiofemoral angulations.

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Study: Bundled Payment Option in Femur Fracture Patients

A retrospective cohort study published in the September issue of the Journal of Orthopaedic Trauma found that a Bundled Payment for Care Improvement initiative may decrease postacute care facility utilization and cost of care in hip and femur fracture patients. Patients who were discharged after undergoing surgical treatment of a hip or femur fracture between January 2015 and October 2016 were divided into two cohorts: bundle (care with initiative, n = 116) and nonbundled (care before initiative, n = 126). Bundle patients had decreased mean lengths of stay (7.3 days versus 6.8 days) and readmission within 90 days (22.2 percent versus 18.1 percent) Among patients discharged to a skilled nursing facility, the bundle cohort saw fewer readmissions (37.3 percent versus 50.6 percent). Readmission rates based on discharged home status did not differ.

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A report from the Centers for Medicare & Medicaid Services (CMS) stated that Medicaid spending hit $592.2 billion in fiscal year 2017, up from $580.9 billion in 2016. Most of the funds went to traditional Medicaid beneficiaries, including children, people with disabilities, and frail individuals Despite waivers that imposed work requirements and coverage lockouts, Medicaid spending is forecasted to grow an average of 5.7 percent each year for the next decade. By 2026, spending is expected to hit $1 trillion, with an enrollment of 82.3 million people.

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According to The Physicians Foundation’s survey of nearly 9,000 doctors, physicians’ views on the use of information technology in practice are mixed. Electronic health records are reportedly their greatest source of professional frustration, and 56 percent of respondents feel that digital records lessen the efficiency of their practices. In respect to telemedicine, it is performed by 18.5 percent of the respondents; however, the practice may differ among generations. Twenty-one percent of doctors 45 years old and younger reported practicing telemedicine compared to 17 percent of older respondents. Paperwork may continue to draw doctors’ ire, but documentation time has been roughly stable. Regarding value-based pay, 56.8 percent of respondents said it will not improve quality of care or reduce costs. Just about half of respondents younger than 45 years do not agree with value-based pay (50.4 percent), while 59.7 percent of those older than 45 years do not agree.

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CMS recently announced it made an error while processing providers’ quality scores under the Merit-based Incentive Payment System (MIPS). Participating providers had the opportunity to allow a CMS staff member to review their applications to ensure there were no errors in the doctors’ data. About 621,700 providers may have been underpaid. CMS said some providers may see changes in their 2019 MIPS payments. Clinicians who believe they were affected can request a targeted review through Oct. 15.

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The Rise of the MD/MBA

Physicians spend a considerable portion of their time in medical school, residency training, and fellowship in clinical training to become proficient in their specialties. Throughout the training process, there is little to no guidance on the business side of medicine. With the evolution of health care and a focus on fiscal management and economics, maintaining a medical practice—whether independent practice or hospital employment—is a challenge. Although experience often is the best teacher, there are gaps in areas such as finance, marketing, and business analytics. To adapt to the evolving healthcare profession, aspiring doctors and practicing physicians are increasingly studying business and medicine concomitantly.

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Academy Adopts Anti-discrimination and Anti-harassment Policy

The Academy recently approved its Anti-discrimination and Anti-harassment Policy and Procedures document, reinforcing the organization’s commitment to a safe workplace and educational arena free of harassment and discrimination. More specifically, all Academy event attendees, including AAOS members, meeting attendees, guests, exhibitors, vendors, suppliers, etc., are expected to conduct themselves in a professional, respectful manner and refrain from unacceptable behavior at AAOS-sponsored events, meetings, and social gatherings. Those who witness unacceptable behavior are encouraged to immediately notify Academy staff.

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