Today’s Top Story
CMS releases draft document for expansion of Recovery Audit Program to Medicare Advantage.
Modern Healthcare reports that the U.S. Centers for Medicare & Medicaid Services (CMS) has issued a request for information regarding an expansion of the Medicare Recovery Audit Program to cover Medicare Advantage and Part D plans. The Affordable Care Act requires the program expansion, although there is no definitive timetable for that to take place. A recently released CMS draft document outlines the implementation and scope of the program. Among other things, the proposal outlines plans for “condition-specific” audits, which would identify diagnoses and/or conditions that may be more likely to be subject to risk-adjusted payment error because they are not supported by medical record documentation. Comments on the Medicare Advantage Recovery Audit Program are due by Feb. 1, 2016. Read more…(registration may be required)
Read the draft document (PDF)…

Other News

Study: Compliance feedback may improve bracing compliance for adolescent idiopathic scoliosis patients.
Data from a study published in the Jan. 6 issue of The Journal of Bone & Joint Surgery suggest that providing compliance feedback regarding brace wear may improve compliance for patients who undergo bracing for adolescent idiopathic scoliosis. The research team conducted a prospective study of 171 patients who were counseled with the use of compliance data (n = 93) or not counseled (n = 78). They found that patients in the counseled group wore their orthoses an average of 13.8 hours per day throughout their management, while noncounseled patients wore their braces an average of 10.8 hours per day. Of patients in the counseling cohort who finished brace treatment, 59 percent did not have curve progression of ≥6° and 25 percent had progression to ≥50° or to surgery. Among patients in the noncounceled cohort, 46 percent did not have curve progression of ≥6° and 36 percent had progression to ≥50° or to surgery. There was a non-significant difference in average curve magnitude between cohorts at initiation of bracing. Read the abstract…

Study: Prior fracture may increase likelihood of chronic widespread bodily pain.
According to a study conducted in the United Kingdom and published online in the journal Archives of Osteoporosis, previous fracture may be associated with an increased likelihood of chronic widespread bodily pain (CWBP). The authors drew data on 501,733 participants (mean age 56.5 years) in the UK Biobank cohort. Overall, 7,130 individuals reported CWBP and 23,177 had a history of fracture affecting the upper limb, lower limb, spine, or hip. The authors found that those with prior fracture were significantly more likely to report CWBP than those without. After adjustment, they found that risk ratios were attenuated but still statistically significant, with a risk ratio of 2.67 for CWBP with spine fractures in men and 2.13 for CWBP with spine fractures in women, and a risk ratio of 2.19 for CWBP with hip fractures in women. Read more…
Read the abstract…

Study: Quality of discharge facility may affect readmission rates.
Data from a study published in the January issue of the journal Health Affairs suggest that the quality of facilities to which patients are discharged could affect 30-day readmission rates. The research team examined the extent to which the Medicare Hospital Readmissions Reduction Program’s current risk-adjustment factors, measures of patient socioeconomic status, and hospital-level factors explain observed differences in readmission rates between safety-net and other hospitals. They found that some difference in readmission rates may be linked to patient socioeconomic status, but also that safety-net hospitals have been assessed only slightly higher readmission penalties under the program compared to other hospitals. Read more…
Read the abstract…

Study: Rodent model suggests NELL-1 combined with BMP-2 may improve bone regeneration.
Findings published online in The American Journal of Pathology suggest that combining the differentiation factor NEL-like molecule-1 (NELL-1) with bone morphogenetic protein (BMP-2) may improve clinical bone regeneration. The researchers used a rodent model to demonstrate that NELL-1 combined with BMP-2 significantly optimizes osteogenesis by minimizing the formation of BMP-2-induced adipose-filled cystlike bone. Read more…
Read the abstract…

Researchers use CMS Open Payments system to examine physician payments from drug and device companies.
A study published in the January issue of the journal Mayo Clinic Proceedings finds that medical specialties that require a higher level of intervention generally receive higher payments from pharmaceutical and device companies. The research team reviewed publicly available data from the CMS Open Payments program. They found that physician specialties most likely to receive general payments were cardiovascular specialists (78 percent) and neurosurgeons (77 percent), while those least likely were pathologists (9 percent). Internal medicine and orthopaedic surgery received the greatest total value, at $111 million each, and orthopaedic surgery and neurosurgery had the greatest mean value of general payments per physician. Read more…
Read the abstract…

California.
An item posted to the website of the Davis Wright Tremaine, LLP law firm notes that California Senate Bill 396 (SB 396) took effect Jan. 1, and increases regulation of ambulatory surgery centers and other outpatient settings. Among other things, the article notes that SB 396 requires affected facilities “to conduct peer review, obtain reports about medical staff applicants and members from state professional licensing boards, and be subject to ‘unannounced’ accreditation inspections—which may be conducted after notice that an inspection will occur within 60 days.” Read more…

Last call: Committee positions closing soon!
A number of openings on the AAOS Committee Appointment Program website are closing soon. Act now to apply for the following positions:

  • Adult Reconstruction Knee Program Committee (nine member openings; closes Jan. 6 [TODAY])
  • Annual Meeting Committee (chair designee; Jan. 11)
  • Exhibits Committee (chair designee; Jan. 11)
  • Physician Consortium for Performance Improvement (liaison; Jan. 10)
  • Team Physician Consensus Conference (liaison; Jan. 7)
  • Practice Management/Rehabilitation Program Committee (chair, seven members; Jan. 7)

Learn more and submit your application…(member login required)