Today’s Top Story
Congress passes SGR repeal; President to sign.
The U.S. Senate has passed and President Obama has indicated his intent to sign a House bill to repeal the Medicare Sustainable Growth Rate formula. The legislation institutes a 0.5 percent increase in Medicare physician reimbursement from July 2015 to December 2015, followed by annual 0.5 percent increases through 2019. In addition, it consolidates various Medicare reporting programs into a new merit-based incentive payment system, extends the Children’s Health Insurance Program, and is designed to stimulate physician participation in alternative payment models. The sweeping legislation also expands availability of Medicare data by allowing qualified clinical data registries to purchase claims data for purposes of quality improvement and patient safety; protects providers from having quality metrics used against them in medical liability suits by clarifying that development of any quality or clinical guideline in Medicare or through other laws cannot be construed to establish a standard of care or duty of care; and reverses a proposed global payments policy announced by the U.S. Centers for Medicare & Medicaid Services, which would have converted all 10- and 90-day global procedure codes to 0-day codes. Read more…
Read more in AAOS Advocacy Now…
Read the response from the American Association of Orthopaedic Surgeons…
Read the bill…
Other News
FDA announces recall of Zimmer component; issues warning about muscle growth supplement.
The U.S. Food and Drug Administration (FDA) has announced a voluntary manufacturer recall of the Persona Trabecular Metal Tibial, manufactured by Zimmer Inc. The agency states that the recall was initiated in response to an increase in complaints of radiolucent lines and loosening. All sizes and lots of the affected devices are being removed from distribution, and all affected products should be located and quarantined immediately. Read more…
FDA has also issued a warning to consumers to stop using Tri-Methyl Xtreme—a dietary supplement for muscle growth distributed by Las Vegas-based Extreme Products Group. The supplement has been linked to serious liver injury. Read more…
Study: Criminal activity associated with most HIPAA electronic data breaches.
A research letter published in the April 14 issue of The Journal of the American Medical Association (JAMA) examines the effect of recent data breaches of unencrypted, protected health information reported by entities covered under the Health Insurance Portability and Accountability Act (HIPAA). The researchers evaluated 949 breaches that occurred between 2010 and 2013 and were recorded in a U.S. Department of Health and Human Services database. They found the breaches affected 29.1 million records, and that most resulted from overt criminal activity. “Given the rapid expansion in electronic health record deployment since 2012, as well as the expected increase in cloud-based services provided by vendors supporting predictive analytics, personal health records, health-related sensors, and gene sequencing technology, the frequency and scope of electronic health care data breaches are likely to increase,” they write. The researchers note that because the data were limited to recognized and reported breaches affecting 500 or more individuals, the study likely underestimates the true number of healthcare data breaches during the time span. Read more…
Read the research letter…
Study: Single dose of zoledronic acid may increase BMD, but not reduce incidence of fractures in older women.
Findings published online in the journal JAMA Internal Medicine suggest that a single dose of zoledronic acid may increase bone mineral density (BMD) in older women. The research team conducted a randomized, placebo-controlled, double-blind study of 181 women 65 years or older with osteoporosis, who received either one 5-mg dose of zoledronic acid or placebo intravenously, along with daily calcium and vitamin D supplementation. At 12- and 24-month follow-up, they found that mean BMD changes at the hip and spine were greater in the treatment group compared to the control group. The treatment and placebo groups’ fracture rates were 20 percent and 16 percent respectively, and mortality rates were 16 percent and 13 percent respectively. Overall, the groups did not differ in proportion of single fallers, but more participants in the treatment group had multiple falls—a difference that did not retain significance after adjustment for baseline frailty. Read more…
Read the abstract…
Study: Intravenous ketamine may be effective for short-term treatment of acute pain in the ED.
According to a study published online in the journal Annals of Emergency Medicine, subdissociative intravenous ketamine may offer effective pain relief and apparent safety comparable to that of intravenous morphine for short-term treatment of acute pain in the emergency department (ED). The authors conducted a prospective, randomized, double-blind trial of 90 patients who received either ketamine at 0.3 mg/kg (n = 45) or morphine at 0.1 mg/kg (n = 45) by intravenous push lasting 3 to 5 minutes. At 30 minutes, they found no significant difference in mean pain scores between cohorts. In addition, there was no difference in incidence of rescue fentanyl analgesia at 30 or 60 minutes, and no statistically significant or clinically concerning changes in vital signs. No serious adverse events occurred in either group. However, patients in the ketamine group reported increased minor adverse effects at 15 minutes post–drug administration. Read the abstract…
Does MOC improve patient care?
A blog post on The New York Times website looks at the issue of physician maintenance of certification (MOC). The article primarily covers MOC issues in internal medicine, but notes that many physicians have voiced dissatisfaction with board certification processes that include high fees and exam questions that may lack relevance to practicing physicians. Critics of recertification say it is an unnecessary drain on physicians whose schedules are already overloaded. Supporters state that physicians who recertify are demonstrating a superior level of commitment to patient care. A pair of studies published recently in JAMA found no correlation between MOC and better patient outcomes, but did note that MOC was associated with a 2.5 percent reduction in Medicare billing. Read more…
Read the statement from the American Board of Orthopaedic Surgery on MOC in the April issue of AAOS Now…
Orthopaedic surgeon tops list of “most meaningful jobs.”
Forbes reports that a survey of workers in more than 400 jobs from the Occupational Information Network finds that “orthopaedic surgeon” tied with “police chief” for “most meaningful job.” Overall, 100 percent of those surveyed in both professions said they find strong meaning in their work. In addition, the survey finds that 88 percent of orthopaedists are male and that their national median pay is $337,800. Read more…
Call for volunteers: ACR Appropriateness Criteria Expert Panels on Musculoskeletal and Neurological Imaging.
AAOS seeks to nominate members to the American College of Radiology Appropriateness Criteria Expert Panels on Musculoskeletal and Neurological Imaging. The representatives will work with the panels to develop and update topics for select musculoskeletal, neurological, and pediatric conditions. 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 with experience in evidence-based guidelines. 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 April 5, 2015 at 11:59 p.m. CT, to Kyle Shah at shah@aaos.org.
Learn more and submit your application…(member login required)
