Today’s Top Story
Initiative focuses on limiting surgeries by low-volume providers.
Three major U.S. health systems—Dartmouth-Hitchcock Medical Center, The Johns Hopkins Hospital and Health System, and the University of Michigan Health Systems—recently announced their “Take the Volume Pledge” campaign, which will be instituted at their combined 20 hospitals. HealthLeaders Media reports that the campaign will focus on limiting the number of surgical procedures performed by so-called “hobbyists,” meaning surgeons and hospitals that rarely perform the procedures in question. The campaign’s goal is to reduce complications caused by insufficient practice by setting minimum volume thresholds on 10 different surgical procedures, including two orthopaedic procedures (total hip and total knee replacement). For hip and knee replacements, the minimum volume threshold for hospitals is an average of 50 procedures (each) annually; for surgeons, it is an average of 25 procedures (each) per year. To accomplish this goal, surgeon volume may be tied to staffing privileges. Read more…
Other News
Senator calls for heightened scrutiny of alleged Medicare Advantage fraud.
Modern Healthcare reports that Senate Judiciary Committee Chairman Chuck Grassley (R-Iowa) recently sent letters to Attorney General Loretta Lynch and Andrew M. Slavitt, acting administrator of the U.S. Centers for Medicare & Medicaid Services (CMS), pressing for more scrutiny regarding allegations of fraud involving Medicare Advantage health plans, which now provide health coverage for approximately 16 million people. In the letters, Sen. Grassley asked what the two agencies have done to address alleged overcharges, noting that “safeguards become all the more important as Medicare Advantage adds more patients and billions of dollars of hard-earned taxpayer money is at stake.” Some experts have questioned the accuracy of a billing tool called a “risk score,” which is meant to pay insurers higher rates for sicker patients. Sen. Grassley asserted that “with the reported increase in risk score gaming, and the monumental cost that the taxpayer will shoulder for such wrongdoing, it is imperative that (the) CMS implement safeguards to reduce risk score fraud, waste and abuse.” Read more…
Study: PAI and PCEA associated with similar functional recovery scores following THA.
According to a study published online in The Journal of Bone & Joint Surgery, use of a multimodal pain regimen including periarticular injection (PAI) does not decrease the time to discharge after total hip arthroplasty (THA), compared to patient-controlled epidural analgesia (PCEA). The study involved 84 THA patients between the ages of 50 and 80 years with similar demographics who were randomized to receive either PAI or PCEA. Both groups were administered dexamethasone (6 mg, orally) preoperatively. The PAI group received a clonidine patch and sustained-release oxycodone (10 mg); the PCEA group received placebo. Postoperatively, both groups received combined spinal-epidural anesthesia and used an epidural pain pump; the PAI group had normal saline solution, and PCEA group had bupivacaine and hydromorphone. The mean time to readiness for discharge and mean length of stay were not significantly different between the groups. However, PAI was associated with higher pain scores and greater opioid consumption, compared with PCEA. Read the study…
GAO makes recommendations on Medicare physician payment rate process.
The U.S. Government Accountability Office (GAO) contends that the Centers for Medicare & Medicaid Services’ (CMS) current process for establishing physicians’ work relative values is flawed and that better data and greater transparency are needed to improve the accuracy of Medicare physician payment rates. The GAO recommends that CMS improve documentation of its process for establishing relative values, and that rulemaking be used to inform the public of Relative Value Scale Update Committee (RUC)-identified services. GAO’s report also recommends that “CMS develop a plan for using funds appropriated for the collection and use of information on physicians’ services in the determination of relative values.” Read the report…
TeamSTEPPS® Advanced Master Training Course update.
The Agency for Healthcare Research and Quality (AHRQ) is funding the development of an Advanced Master Training Course to build upon the traditional 2-day Master Training Course. The Health Research & Educational Trust of the American Hospital Association is sponsored by AHRQ to run that National Implementation of TeamSTEPPS contract and this training. This unique course is not a TeamSTEPPS refresher but an enriched training to foster leadership development and the growth of dedicated TeamSTEPPS participants committed to improving patient safety by better integrating, spreading, and sustaining TeamSTEPPS. The training consists of a hybrid (online and in-person) cohort-based model to be completed over the course of 1 month. The application period for courses held in July closes on May 29. For more information…
Massachusetts.
Declaring that opioid abuse has reached the “crisis point,” the Massachusetts Medical Society (MMS) is launching “a comprehensive campaign to educate prescribers and the public about the safe and responsible prescribing” of opioid drugs. In a report titled “Bold Steps to End the Opioid Epidemic—The Physician Contribution to the Solution,” MMS President Dennis M. Dimitri, MD, explains that the initiative has three main components:
- Guidelines to help physicians make the right decisions for their patients
- Free education resources for prescribers to help inform their judgments
- Storage and disposal information for patients and their families
The society will ask the state Board of Registration medicine to incorporate its recommendations into its prescribing guidelines for physicians. Read more…
Read the MMS guidelines…
Read the JAAOS article on the opioid epidemic…
Last chance to vote! AAOS 2016 Nominating Committee, six resolutions, and three bylaw amendments.
Only 5 days remain to elect the six members of the 2016 Nominating Committee and to determine action on six AAOS resolutions and three bylaw amendments. Online voting is quick, secure, and confidential. For the resolutions and bylaw amendments, at least 20 percent of the total fellowship must cast ballots for the voting to be valid. Ballots must be submitted by Wednesday, May 27, 2015. If you have questions, please contact the AAOS Voting Hotline, at 800-999-2939. Submit your ballot…(member login required)
Call for volunteers: White House Champion of Change for Precision Medicine.
AAOS seeks to nominate members to the White House Champion of Change for Precision Medicine initiative, a new research effort that aims to revolutionize disease treatment and improve health. 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, a 100-word biosketch, and a letter of interest highlighting his or her expertise in the subject area. All supporting materials must be submitted to Kyle Shah by May 26, 2015 at 11:59 p.m. CT, at shah@aaos.org.
Learn more and submit your application…(member login required)
