Today’s Top Story
Supreme Court declines to hear IPAB challenge.
Politico reports that the U.S. Supreme Court has declined to hear a challenge contesting the constitutionality of the Independent Payment Advisory Board (IPAB)—a panel created under the Affordable Care Act (ACA) and designed to control Medicare costs. The decision lets stand a lower court ruling, which determined that the board’s constitutionality cannot be contested until after it convenes and takes action. Under the ACA, IPAB does not convene unless growth in Medicare spending exceeds certain levels. A representative of the organization that brought the suit states that it reserves the right to refile the challenge in the future, after IPAB is seated and begins to act. Read more…
Read the lower court decision (PDF)…
Other News
SGR bill includes provision to prevent use of federal guidelines in medical liability cases.
According to The New York Times, a provision of the SGR repeal legislation passed last week by the U.S. House of Representatives would, if enacted, protect healthcare providers from some lawsuits by stipulating that quality-of-care standards used in federal health programs cannot be used in medical liability cases. A spokesperson for one medical liability insurer states that standards of care relevant to medical liability cases should be established by the testimony of experts, not reference to federal guidelines. However, critics of the provision argue that it would make it more difficult for nursing home residents to legally establish negligence by showing that a home had violated federal health and safety standards. The bill, approved in the House last week, will be taken up by the Senate when it returns on April 13. The American Association of Orthopaedic Surgeons advocated strongly for the medical liability provision to be included in this bill. Read more…
Supreme Court: Providers can’t sue to challenge Medicaid reimbursement.
A decision by the U.S. Supreme Court finds that healthcare providers cannot sue to challenge Medicaid reimbursement rates. As reported by The Washington Post, healthcare providers sued the state of Idaho, arguing that reimbursement rates set by the state for service provided to people with developmental disabilities were too low to comply with the federal Medicaid law. A lower federal court agreed, but the Supreme Court ruled that Medicaid payments are not open to private lawsuits. The Supreme Court noted that healthcare providers have the option to pursue relief through the Secretary of the Department of Health and Human Services (HHS), who may then issue notice to the state that its payment scheme is inadequate. HHS has the power to withhold funds to states that fail to comply with federal Medicaid requirements. Read more…
Read the Supreme Court decision (PDF)…
Study: Similar likelihood of mortality for older patients who undergo surgical or nonsurgical treatment of acetabular fractures.
Findings published in the April issue of the Journal of Orthopaedic Trauma (JOT) suggest that surgical treatment of acetabular fractures may not be associated with increased or decreased mortality among older patients. The authors conducted a retrospective study of 454 patients aged 60 years or older who presented with acetabular fractures at one of three Level I trauma centers. At 1-year follow-up, they found that overall mortality was 16 percent. Unadjusted survivorship curves suggested higher 1-year mortality rates for nonsurgically treated patients, but nonsurgical treatment was associated with other risk factors. After adjustment for those factors, the authors found no significant difference in hazard of death for nonsurgical treatment, or for any of three surgical treatment subgroups—percutaneous reduction and fixation, open reduction and internal fixation, and acute total hip arthroplasty. Read the abstract…
Study: Meta-analysis suggests acetaminophen not effective for low back pain, and offers only short-term benefit to OA patients.
Data from a study published online in the journal The BMJ suggest that acetaminophen may be ineffective in the treatment of low back pain and may offer only minimal short-term benefit for patients with osteoarthritis (OA). The research team conducted a systematic review and meta-analysis of 13 randomized trials and found high quality evidence that acetaminophen was ineffective for reducing pain intensity and disability, or improving quality of life in the short term among people with low back pain. For hip or knee OA, they found high quality evidence that acetaminophen had a significant, but not clinically important, effect on pain and disability in the short term. Overall, the rates of adverse events were similar between acetaminophen and placebo groups. The research team noted high-quality evidence that patients taking acetaminophen were nearly four times more likely to have abnormal results on liver function tests. However, they write that the clinical importance of that effect remains uncertain. Read more…
Read the abstract…
Study: Initial nonsurgical treatment of midshaft clavicle fractures generally more cost-effective than initial surgical fixation.
According to data published in the April issue of JOT, initial nonsurgical treatment of midshaft clavicle fractures followed by delayed surgery as needed is less costly than initial surgical fixation. The researchers conducted a meta-analysis of four randomized, controlled trials that compared surgical and nonsurgical treatment of displaced midshaft clavicle fractures in adults with minimum 1-year follow-up. They found that expected costs for surgical treatment were $14,763.21, compared to $3,112.65 for nonsurgical treatment. They found that overall costs for initial nonsurgical treatment were associated with reduced cost to the healthcare system until delayed surgical treatment approached 95 percent and reoperation after initial surgical management fell below 15 percent. Read the abstract…
Survey looks at orthopaedic residency program expectations.
A survey published online in the journal Clinical Orthopaedics and Related Research looks at residents’ and program directors’ (PDs’) expectations and perceptions of residency training. The research team surveyed orthopaedic surgery resident and PD members of the Midwest Orthopedic Surgical Skills Consortium. They found that both groups agreed on current resident time allocation across 10 domains. However, they disagreed on multiple components of an idealized program, with residents desiring more time spent in the operating room (OR) than what PDs thought was necessary. In addition, residents showed a preference for more time spent deliberately practicing surgical skills outside of the OR. Both groups wanted residents to spend less time completing paperwork. Read the abstract…
Call for volunteers: NQF Measure Applications Partnership.
AAOS seeks to nominate members to the National Quality Forum (NQF) Measure Applications Partnership (MAP). The purpose of the MAP is to provide input to HHS on the selection of performance measures for public reporting and performance-based payment programs. 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 to Kyle Shah by April 7, 2015, at 11:59 p.m. CT at shah@aaos.org.
Learn more and submit your application…(member login required)
