Today’s Top Story
Journal article calls for increased transparency and standardization of medical error reporting.
According to an article published in the June issue of The Joint Commission Journal on Quality and Patient Safety, lapses in patient safety are linked to more than 200,000 deaths, 2.4 billion extra hospital days, and approximately $17 billion to $29 billion in excess hospital costs in the United States each year. The authors state that only 26 states and Washington, D.C. require mandatory reporting of adverse medical errors. In addition, they note that “preventable medical errors” is not defined consistently across organizations and regulatory agencies. Read more…
    On a related note, the National Patient Safety Foundation (NPSF) has released a set of guidelines on root cause analysis; the guidelines were developed to help healthcare organizations improve the way they investigate medical errors, adverse events, and near-misses. Read more…
Read the complete NPSF report (PDF)…

Other News

House leaders plan to move forward with ACA-related legislation.
According to The Hill, leaders in the U.S. House of Representatives plan to move forward with bills to repeal the medical device tax and the Medicare Independent Payment Advisory Board (IPAB). In addition, House Speaker John Boehner states that House leadership has a plan to address or mitigate a possible loss of Affordable Care Act subsidies, should the U.S. Supreme Court agree with the plaintiffs in King v. Burwell. The plaintiffs argue that the ACA intends subsidies to be granted only to those who purchase insurance via state-operated healthcare exchanges. Read more…
    A separate article in The Hill notes that President Obama has threatened to veto any repeal of the medical device tax. Read more…
Read more about the IPAB repeal legislation and AAOS efforts in Advocacy Now…

Study: Arthroscopic intervention may offer only minimal and short-term reduction in knee pain.
Data from a study published online in the journal The BMJ suggest that arthroscopic intervention may offer only minimal and short-term benefit for middle-aged or older patients with knee pain. The researchers conducted a systematic review and meta-analysis of nine randomized, controlled trials that assessed the benefits of arthroscopic knee surgery in middle-aged and older patients with knee pain and degenerative knee disease. They noted a small difference favoring intervention (including arthroscopy) compared with control treatments for pain. However, the benefits were not evident at 24-month follow-up, and the researchers found no significant benefit on physical function. Negative effects associated with interventions included symptomatic deep venous thrombosis, pulmonary embolism, infection, and death. Read more…
Read the abstract…
    AAOS has issued a clinical practice guideline (CPG) and an appropriate use criteria (AUC) regarding treatment of osteoarthritis of the knee. Read the CPG…
Read the AUC…

Study: Bisphosphonate use fell after reports of safety concerns.
A study published online in the Journal of Bone and Mineral Research suggests that the use of bisphosphonates declined in the United States by more than 50 percent in recent years. The research team drew data from the Medical Expenditure Panel Survey and the National Inpatient Sample to estimate trends in oral bisphosphonate use among patients aged 55 years and older, as well as hospitalizations for intertrochanteric and subtrochanteric fractures. They found that, after increasing for more than a decade, use of bisphosphonates fell more than 50 percent between 2008 and 2012, and that a plateau and decline in oral bisphosphonate use since 2006 coincided with reports of safety concerns of bisphosphonates. The research team noted that, although the number of intertrochanteric hip fractures declined from 1996 through 2012, subtrochanteric and diaphyseal fractures showed a steady and significant increase from 2002 to 2011. Read more…
Read the abstract…

MedPAC report proposes limits for RACs.
The U.S. Medicare Payment Advisory Commission (MedPAC) has released its June 2015 Report to the Congress: Medicare and the Health Care Delivery System. Among other things, the report recommends that the secretary of the U.S. Centers for Medicare & Medicaid Services (CMS) take the following steps:

  • Direct recovery audit contractors (RACs) to focus reviews of short inpatient stays on hospitals with the highest rates of this type of stay
  • Modify contingency fees to be based, in part, on RAC’s claim denial overturn rates
  • Ensure that the RAC look-back period is shorter than the Medicare rebilling period for short inpatient stays
  • Withdraw the so-called “two-midnight” rule

Read more (PDF)…
Read the report fact sheet (PDF)…

House spending bill would cut HHS overall, but increase CDC and NIH funding.
The Hill reports that a House appropriations panel today approved a 2016 funding measure that, if enacted, would cut $4 billion from the 2015 Labor-HHS-Education appropriation level, but increase funding for the Centers for Disease Control and Prevention (CDC) by $140 million and for the National Institutes of Health (NIH) by $1.1 billion. Specifically, the bill increases funding for key research programs, such as those focused on rural states and the President’s Precision Medicine Initiative. Observers say the proposed increases are also driven in part over concerns about Ebola. Committee Chairman Tom Cole (R-Okla.) said he expects a full committee markup next week. Committee Chair Tom Cole (R-Okla.) says he expects a full committee markup next week. Read more…
     The funding announcement comes several months after orthopaedic surgeons and their patients met with members of Congress to discuss the need for increased musculoskeletal research funding. The physicians and their patients specifically urged Congress to appropriate adequate funding to NIH. Read more…

Reminder: July 1 is last day to file for meaningful use hardship exception and avoid 2016 pay adjustment.
Healthcare providers have until July 1 to file a hardship exception and avoid a 2016 payment adjustment for unsuccessful participation in the Medicare EHR Incentive Program in 2014. To file a hardship exception, providers must take the following steps:

  • Show proof of a circumstance beyond their control
  • Explicitly outline how the circumstance significantly impaired their ability to meet meaningful use requirements

If approved, the exception is valid for the 2016 payment adjustment only. Supporting documentation must be provided for certain hardship exception categories. If a hardship exception is to be claimed for a subsequent payment adjustment year, a new application must be submitted for the appropriate year. Read more…
Learn more about hardship exceptions…

Last call: AHRQ National Advisory Council for Healthcare Research and Quality.
AAOS seeks to nominate members to the Agency for Healthcare Research and Quality (AHRQ) National Advisory Council for Healthcare Research and Quality. The council advises the secretary of the U.S. Department of Health and Human Services and the director of AHRQ on improving the quality, safety, efficiency, and effectiveness of health care. 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 their expertise in the subject area and a statement that they are able to participate in full capacity. All supporting materials must be submitted to Kyle Shah by Sunday, June 21, 2015 at 11:59 p.m. CT, at shah@aaos.org.
Learn more and submit your application…(member login required)