Today’s Top Story
Study: Adding stem cells may improve microfracture outcomes for patients with symptomatic knee cartilage defect.
According to data from a study conducted in Korea and published in the journal Arthroscopy, microfracture (MFX) and adipose-derived stem cells (ADSCs) with fibrin glue may offer improved outcomes compared to MFX alone for patients with symptomatic knee cartilage defects. The prospective, randomized study involved 80 patients aged 18 to 50 years who had a single International Cartilage Repair Society grade III/IV symptomatic cartilage defect (≥3 cm2) on the femoral condyle. At mean 24.3-month follow-up, they found that 65 percent (n = 26) of patients in the ADSC cohort had complete cartilage coverage of the lesion, compared to 45 percent (n = 18) of patients in the control cohort. In addition, at mean clinical follow-up of 27.4 months, the authors found significantly greater improvement in mean Knee Injury and Osteoarthritis Outcome Score pain and symptom subscores in the ADSC group. However, they noted no significant difference between groups regarding improvements in other subscores (activities of daily living, sports and recreation, and quality of life). Read the abstract…
Other News
Study: CMMI bundled payment initiative sees increased adoption.
Data published online in The American Journal of Managed Care suggest increasing adoption of a bundled payment model for medical care. The research team reviewed data on the U.S. Center for Medicare & Medicaid Innovation (CMMI) Bundled Payments for Care Improvement (BPCI) initiative. They found that overall participation in BPCI increased from about 400 providers in October 2013 to more than 2,000 providers in June 2014. Physician groups account for about half of current participants, and orthopaedic practices account for 19 percent of all participating physician groups. For hip arthroplasty procedures, hospitals participating in BPCI Model 2 (the most comprehensive of the 4 models) were not costlier than their peers. The research team noted that most BPCI participants have not yet begun to bear financial risk, and that risk-bearing Model 2 hospitals are a smaller and less representative group, with higher baseline costs for hip arthroplasty compared to their peers. Read the complete study…
Study: Patients at safety net hospitals may see higher complication rate after hip and knee arthroplasty.
Findings from a study published online in The Journal of Arthroplasty suggest that patients may be at increased risk of complication after hip and knee arthroplasty at a safety net hospital compared to the same procedure performed at a university medical center. The retrospective review examined 533 consecutive hip and knee arthroplasties performed by a single experienced surgeon at a safety-net hospital and a university center. At minimum 2-year follow-up, 8 percent of patients in the safety net group had a revision, compared to 20.5 percent of patients at the university hospital. However, in terms of total complications, deep infections, and reoperations, the rate of adverse outcomes was significantly higher in the safety net cohort. Read the abstract…
Consumer advocacy report card finds most states rank low on physician quality information.
The nonprofit Health Care Incentives Improvement Institute reports that 41 states and the District of Columbia received a failing grade on the organization’s State Report Card on Transparency of Physician Quality Information. The organization awards each state a grade based on the number of primary care and specialty care physicians for whom healthcare quality information is publicly reported. Criteria include scope of transparent quality information, scope of measures, and accessibility of information. According to the report card, only Minnesota and Washington earned As, while Maine was the only state to receive a B. Read more…
View the report card (PDF)…
CMS proposed rule would address narrow networks sold on federal ACA exchange.
Among other things, a rule released by the U.S. Centers for Medicare & Medicaid Services attempts to address the effect on consumers of narrow provider networks under health plans sold on the federal Affordable Care Act (ACA) insurance exchange during 2017. Under the rule, insurers would be required to provide written notice to enrollees of discontinuation of a provider “30 days prior to the effective date of the change or otherwise as soon as practicable.” If the provider is terminated without cause, a second provision would require the insurer to allow an affected enrollee to continue treatment until the treatment is complete or for 90 days (whichever is shorter) at in-network cost-sharing rates. Further, CMS proposes that insurers be required to count cost sharing charged to the enrollee for certain out-of-network services (provided at an in-network facility) towards the enrollee’s annual limitation on cost sharing. Read more…(registration may be required)
Read the CMS summary (PDF)…
Read the complete rule (PDF)…
Study: One-third of former athletes surveyed report at least one undisclosed concussion.
Survey data published online in The American Journal of Sports Medicine suggest that many self-identified sports-related concussions (SISRCs) may go undisclosed. The research team surveyed 797 former collegiate athletes and found that 214 (26.9 percent) reported sustaining at least one SISRC. Of those, 71 (33.2 percent of subset) reported at least one undisclosed SISRC. The prevalence of nondisclosure was higher among men than women. The most commonly reported motivations for nondisclosure were as follows: did not want to leave the game/practice (78.9 percent), did not want to let the team down (71.8 percent), did not know it was a concussion (70.4 percent), and did not think it was serious enough (70.4 percent). Read the abstract…
Study: Patients often overestimate physician reimbursement for orthopaedic spine surgery.
According to information published in the Nov. 1 issue of The Spine Journal, many patients who undergo orthopaedic spine surgery lack understanding of physician compensation. The researchers surveyed patients using a 12-question survey and found that, in general, patients understood which procedures resulted in the greatest reimbursement to a spine surgeon, but the majority significantly overestimated the amount surgeons are reimbursed per procedure. In addition, those surveyed tended to believe that surgeons were provided extra compensation for care in the immediate postoperative period and for postoperative clinic visits. Overall, about 3 percent of respondents considered surgeons to be overpaid, while nearly 25 percent considered them underpaid. Read the abstract…
Last call: NQF Variation in Measure Specifications Project.
AAOS seeks to nominate members to the National Quality Forum (NQF) Variation in Measure Specifications Project. NQF is initiating a project focused on Variation in Measure Specifications to identify how, where, and why variation is occurring across current measures; to create a framework for understanding and interpreting the different types of variation across measures and the implications of this variation; and to develop a common understanding around key terms, concepts, and measure components to help standardize measurement efforts and minimize unnecessary variation. 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 and a statement that he or she is able to participate in full capacity. All supporting materials must be submitted by Sunday, Nov. 29, 2015 at 11:59 p.m. CT, to Kyle Shah at: shah@aaos.org
Learn more and submit your application…(member login required)
