Today’s Top Story
CMS releases proposed rule for physician reimbursement under MACRA.
The U.S. Centers for Medicare & Medicaid Services (CMS) has released a proposed rule detailing the physician reimbursement framework required by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The American Association of Orthopaedic Surgeons (AAOS) has previously communicated with CMS on the implementation of select provisions of MACRA, including episode groups, aspects of the Merit-Based Incentive Payment System, developing alternative payment models, and encouraging creation of physician-focused payment models. AAOS leadership and staff are closely reviewing today’s proposed rule and will provide CMS with detailed comments.
Study: Trabecular bone score may be significant predictor of fracture risk.
Findings from a study published online in the Journal of Bone and Mineral Research suggest that trabecular bone score (TBS) may be a significant predictor of fracture risk independent of the Fracture Risk Assessment Tool (FRAX). The researchers conducted a meta-analysis of 17,809 people in 14 prospective, population-based cohorts. At mean 6.7-year follow-up, they found that the gradient of risk of TBS for major osteoporotic fracture was 1.44. When additionally adjusted for FRAX 10-year probability of major osteoporotic fracture, they found that TBS remained a significant, independent predictor for fracture. The researchers state that their findings support the use of TBS as a potential adjustment for FRAX probability, although “the impact of the adjustment remains to be determined in the context of clinical assessment guidelines.”
Read the abstract…
FDA announces recall of one lot of Sensorcaine®-MPF (bupivacaine HCl) Injection.
The U.S. Food and Drug Administration (FDA) has announced a voluntary recall of one lot of Sensorcaine®-MPF (bupivacaine HCl) Injection, USP, 0.75%, 7.5 mg/mL, 30 mL fill in a 30 mL vial, manufactured by Fresenius Kabi USA. The recall has been initiated due to visible particulate matter characterized as glass observed by the company during inspection of reserve samples. The manufacturer is notifying distributors and customers by letter and is arranging for return of all recalled product. If healthcare facilities have the affected lot, they are to immediately discontinue distributing, dispensing, or using the lot and return all units to Fresenius Kabi.
Three health systems agree to limit certain procedures to higher volume surgeons and hospitals.
According to Kaiser Health News, three health systems have recently agreed to the “Volume Pledge,” which is designed to prevent certain surgical procedures from being performed by surgeons who perform relatively few such procedures, or at hospitals where few such procedures are performed. The systems, which cover 20 affiliated hospitals, will now require minimum annual thresholds for 10 high-risk procedures, including hip and knee arthroplasty procedures, which will require 25 per surgeon and 50 per hospital. The agreement includes provisions for emergency surgery and for surgeons who may not meet the threshold because they were on leave; such surgeons might be required to perform a certain number of procedures under supervision. The three systems have asked other hospital networks around the country to join them. A number of studies have suggested that higher institutional and per-surgeon volumes may be associated with improved outcomes for certain procedures.
A perspective piece published in the Oct. 14, 2015 issue of The New England Journal of Medicine discussed the “Volume Pledge.”
IOF panel releases consensus statements on use of osteoporosis medications after incident fracture.
An International Osteoporosis Foundation (IOF) working group has released a set of consensus statements regarding the use of osteoporosis medications after incident fracture and use of such medications to enhance delayed fracture healing. Among other things, key panel agreements included:
- It is valuable to identify patients at increased risk of delayed fracture healing as early as possible in order to consider intervention.
- There was no evidence for delay in fracture healing when injectable bisphosphonates were given in the first 2 weeks after fracture.
- Anabolic agents such as teriparatide, which enhance osteoblastic bone formation, may have a beneficial effect on fracture healing.
- After occurrence of an atypical femur fracture, bisphosphonate therapy should be stopped.
Nominate a colleague for the AAOS Diversity, Humanitarian, or Tipton Leadership Award!
Friday, June 10, 2016 is the last day to submit nominations for the 2017 Diversity and Humanitarian Awards, and the William W. Tipton Jr., MD, Orthopaedic Leadership Award. These awards are presented annually at the AAOS Annual Meeting. The respective award recipients are recognized for their endeavors to further encourage diversity or culturally competent care, participation in humanitarian activities, or leadership activities in the orthopaedic profession.
AJRR, AOA, and AAHKS to collaborate on quality efforts though Orthopaedic Quality Resource Center.
The American Joint Replacement Registry (AJRR), the American Orthopaedic Association (AOA), and the American Association of Hip and Knee Surgeons (AAHKS) have announced a collaborative effort to align quality initiatives and reporting through the AJRR Orthopaedic Quality Resource Center, approved by the Centers for Medicare & Medicaid Services (CMS) as a Qualified Clinical Data Registry (QCDR). Under this new collaboration, the organizations will cooperate in offering the QCDR to eligible professionals and group practices interested in submitting Physician Quality Reporting System (PQRS) measures. The new collaboration will also result in additional measures to be included in the AJRR Orthopaedic Quality Center platform in 2016, including two additional post-fracture PQRS measures, and four additional custom measures documenting process and outcomes for hip arthroplasty patients. With these additions, the AJRR QCDR approved for 2016 includes a total of 38 PQRS and custom measures.
Visit the QCDR…