Today’s Top Story
ACA future unclear in the wake of oral arguments in King v. Burwell case.
A U.S. Supreme Court decision in King v. Burwell—a case that could jeopardize the fiscal foundation of the Affordable Care Act (ACA)—isn’t expected until June. However, observers of oral arguments on Wednesday noted that Associate Justice Anthony M. Kennedy expressed concerns about a potentially unconstitutional use of coercion, should the high court accept the plaintiffs’ position that the ACA intends subsidies to be granted only to those who purchase insurance via state-operated healthcare exchanges. Justice Kennedy cited the principal of “constitutional avoidance,” in which the court reads a law to avoid potential problems with constitutionality, suggesting possible support for the Obama administration’s argument that the law intended subsidies to be made available to consumers on the federally operated exchange as well. Justice Kennedy and Chief Justice John G. Roberts, Jr., are widely viewed as the potential swing votes in the upcoming decision. Read more…
An article from NPR profiles state-level proposals to address changes to the ACA, should the Supreme Court rule in favor of the plaintiffs in King v. Burwell. Read more…
Other News
AAOS and other organizations call for improved assessment of provider readiness for transition to ICD-10.
In a letter to the U.S. Centers for Medicare & Medicaid Services (CMS), the American Association of Orthopaedic Surgeons (AAOS), the American Medical Association, and 98 other medical organizations have expressed concern that ICD-10 claims testing conducted by the agency may not offer an accurate profile of provider readiness. “CMS is only planning on testing with 850 claims submitters per testing week for a total of 2,550 testers,” the writers state. “This represents a very small fraction of all Medicare providers and an even smaller universe of claims submitted each year. In addition, because the testing participants are volunteers, it is possible that those most confident of their preparation self-selected into the testing program—so that the numbers of successful efforts are not representative.” During ICD-10 testing conducted during the last week of January 2015, CMS received 14,929 test claims, of which 12,149 (81 percent) were accepted. Read more…
Read the letter (PDF)…
Study: Periarticular injection may reduce pain and side effects compared to epidural analgesia for patients undergoing simultaneous bilateral TKA.
According to findings published in the March 4 issue of The Journal of Bone & Joint Surgery (JBJS), periarticular injection may offer improved pain relief and reduced side effects compared to epidural analgesia following simultaneous bilateral total knee arthroplasty (TKA). The authors conducted a randomized, controlled trial of 71 patients (142 knees) undergoing simultaneous bilateral TKA, and found that, during the initial 24-hour period after surgery, postoperative pain at rest, prevalence of nausea, and prevalence of pruritus were significantly lower in the periarticular injection group compared to the epidural analgesia group. Read the abstract…
Study: Trauma center treatment linked to reduced risk of mortality for patients with unstable pelvic and severe acetabular injuries.
Data from a study published in the Feb. 18 issue of JBJS suggest that treatment in a trauma center of patients with unstable pelvic and severe acetabular injuries may be associated with reduced risk of mortality compared to treatment in a hospital that is not a trauma center. The researchers reviewed data on 829 adult trauma patients who had at least one pelvic ring or acetabular injury (Orthopaedic Trauma Association classification of 61 or 62), and who were treated at one of 18 level-I trauma centers or 51 non-trauma centers in the United States. After adjustment, they found that among patients with more severe acetabular injuries, in-hospital mortality, death within 90 days, and death within 1 year were all at significantly lower likelihood at trauma centers compared with non-trauma centers. Patients with combined pelvic ring and acetabular injuries treated at a trauma center had lower mortality rates at 90 days and 1 year. The researchers also noted that care at a trauma center was associated with mortality risk reduction for patients with unstable pelvic ring injuries. Read the abstract…
Study: Short visual test may improve sideline detection of concussion.
According to information published online in the Journal of Neuro-Ophthalmology, use of a vision-based performance measure may enhance the detection capabilities of current sideline concussion assessment systems. The research team conducted a prospective study of 243 youth and 89 collegiate athletes, who underwent preseason, baseline assessment using the King-Devick (K-D) test, a visual performance measure of rapid number naming; the Standardized Assessment of Concussion (SAC), a cognition test; and a timed tandem gait test of balance. Both the SAC and timed tandem gait are components of the currently used Sport Concussion Assessment Tool, 3rd Edition (SCAT3 and Child-SCAT3). The research team found that, among 12 athletes who sustained concussions during their athletic season, K-D scores worsened from baseline by an average of 5.2 seconds, while improvement by 6.4 seconds was noted among 14 nonconcussed control participants. Among the three testing protocols, the K-D test demonstrated the greatest capacity to distinguish concussed vs. control athletes based on changes from preseason baseline to postinjury. Read more…
Read the abstract…
Missouri.
The Columbia Missourian reports that a bill under consideration in the Missouri House of Representatives would, if enacted, cap noneconomic damages in medical liability cases at $350,000. A previous limit on noneconomic damages in such cases was overturned by the state Supreme Court. A sponsor of the bill states that it would create a statutory cause of action for medical liability cases, which is expected to keep the caps in line with the court’s previous ruling. Supporters of the proposal say the caps are needed to make sure physicians do not exit the state due to increasing insurance costs. Opponents argue that juries should be trusted to properly award damages. Read more…
New My Academy app can help plan your educational experience at the AAOS Annual Meeting.
AAOS’ new My Academy app features planning and navigation tools to help attendees take control of their educational opportunities at the AAOS Annual Meeting. Attendees who have already registered for the AAOS 2015 Annual Meeting should have received an email with their personal app activation code. The registration code helps tailor the app to individuals by saving information on sessions for which they have registered. If you have already registered but need help finding your personal activation code, please contact AAOS customer service at: customerservice@aaos.org
Learn more about the My Academy app (video)…
If you have not yet registered for the AAOS Annual Meeting, online registration will remain open through March 13. You will receive your personal My Academy app activation code via email shortly after registration. Register for the AAOS Annual Meeting…
Read the March issue of AAOS Now on your tablet!
The March edition of AAOS Now magazine is now available for electronic devices capable of reading files in ePub format, including the iPhone and iPad, Android devices, and desktop computers (unfortunately, Amazon Kindle does not currently accept ePub files). To download and view the ePub version of AAOS Now, visit the link below and log in using your AAOS username and password. If you have comments or questions about the ePub version of AAOS Now, please email Peter Pollack, electronic content specialist, at ppollack@aaos.org.
Download and read AAOS Now in ePub format…(member login required)
