COVID-19 Updates

CMS Applies MIPS Extreme and Uncontrollable Circumstances Policy to Qualifying Physicians

The Centers for Medicare & Medicaid Services (CMS) extended the 2019 Merit-based Incentive Payment System (MIPS) data submission deadline to April 30 at 8 pm E.S.T. CMS also announced that the MIPS automatic extreme and uncontrollable circumstances policy will apply to eligible clinicians who are unable to submit their data by the April 30 deadline. Qualifying clinicians will be identified automatically, without having to take any additional action, and will receive a neutral payment adjustment for the 2021 MIPS payment year. CMS also reopened the MIPS extreme and uncontrollable circumstances application. Individual clinicians and groups that started but cannot complete their data submission, as well as virtual groups that are unable to start or complete their data submission, should apply. Applications submitted between April 3 and April 30 citing COVID-19 will override all previous data submissions. Contact the Quality Payment Program at 866-288-8292, Monday through Friday, 8 a.m. to 8 p.m. E.S.T. or by email at

Download the Quality Payment Program COVID-19 Response Fact Sheet…

In Other News

Study: Does Resilience Predict Patient Satisfaction with Nonopioid Pain Management, PROMs in Knee Arthroscopy?

A study published online in Arthroscopy measured the predictive value of the Brief Resilience Score (BRS) for patient satisfaction with nonopioid pain management as well as patient-reported outcome measures (PROMs) after arthroscopic partial meniscectomy and/or chondroplasty. Patients were preoperatively stratified into two groups: low/normal resilience and high resilience, measured by the BRS. The Hospital Consumer Assessment of Healthcare Provider and Systems questionnaire was used to measure nonopioid pain management satisfaction at two weeks postoperatively. PROMs were assessed at three and six months after surgery. Satisfaction with nonopioid pain control and PROMs at three and six months did not largely differ between the low/normal and high resilience groups. Visual analog scale (VAS) for pain; Knee Injury and Osteoarthritis Outcome Score for pain, activities of daily living, and quality of life; Single Assessment Numeric Evaluation of the knee; and Veterans RAND 12 Item Health Survey physical component and mental component scores followed expected postoperative trajectories and did not largely differ between the groups

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Study: Elective versus Fracture THA Cases

A study published online in The Journal of Arthroplasty compared preoperative profiles and outcomes between elective total hip arthroplasty (THA) patients versus those treated for fracture. Elective and femoral neck fracture THA patient data were obtained from an administrative claims database; data collection included 90-day readmission rates as well as in-hospital and 90-day post-discharge rates of local and systemic complications. Most primary THAs (n = 76,424; 91.7 percent) were elective. Fracture patients were more likely to be older, not obese, and have a greater comorbidity burden. Average length of stay, all complications rates, and 90-day costs were significantly higher for fracture patients.

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Study Compares Chronic Ankle Instability Treatments

A retrospective study published online in Foot & Ankle International compared the arthroscopic versus open Brostrom-Gould technique to treat chronic ankle instability. Ankles that underwent either arthroscopic (n = 26) or open treatment (n = 26) were matched 1:1 for age, sex, and body mass index. Six- and 12-month clinical outcomes were ascertained using VAS, American Orthopaedic Foot & Ankle Society (AOFAS) Ankle-hindfoot, and Short Form 36 Health Survey scores. Arthroscopic patients had significantly lower levels of perioperative pain and higher AOFAS scores at six and 12 months. No complications were reported. The rate of preoperative intra-articular abnormalities was lower in the arthroscopic group (76.9 percent) than the open group (92.3 percent).

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Study: When Do Professional Baseball Players Return to Batting After Ulnar Collateral Ligament Reconstruction?

A study published online in The American Journal of Sports Medicine determined return to batting milestones among professional baseball players following ulnar collateral ligament reconstruction (UCLR). Between 2010 and 2018, 141 UCLRs were performed in 137 position players; 86 percent were minor league players. The majority of surgeries (96 percent) were performed in the dominant arm. All four players who underwent revision did so within the first year of the index surgery. There was an overrepresentation of catchers and shortstops. More than half of players (57 percent) batted from the right side; 12 percent were switch hitters. About three-quarters of surgeries (76 percent) were on the trail/back arm. Most players (91 percent) returned to some form of throwing, but as the rehabilitation process progressed, a slow decline was observed, with only 77 percent returning to hitting and 75 percent returning to fielding in real games. Milestone “firsts” documented included: dry swing, 150 days postoperatively; batting practice, 195 days postoperatively; hitting in a real game, 323 days postoperatively; and fielding in a real game, 343 days postoperatively. Utilization typically decreased, as players had fewer at bats and subsequently fewer hits and runs.

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Speaking the Same Language

Recently, AAOS Now received several letters taking issue with a series written by Alan M. Reznik, MD, MBA, FAAOS, which used the term “lateral violence” to describe poor behavior and bullying in orthopaedic training programs. Although many letters were supportive, some writers took issue with whether bullying and other adverse behaviors really rise to the level of “violence.” Eeric Truumees, MD, FAAOS, editor-in-chief of AAOS Now, discusses the history of the term and the wide ranging reaction to its use.

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Experience the AAOS 2020 Annual Meeting Content Virtually

Despite the cancelled event, AAOS remains committed to delivering world-class education to the entire orthopaedic community. Whether or not the meeting was in your plans last month, AAOS invites you to the Annual Meeting Virtual Experience. Immerse yourself online in new exciting medical, clinical, and scientific research. View the 2020 award-winning videos on the Orthopaedic Video Theater. Explore the Industry Exhibit content and hear from your Academy leadership—from wherever you are. Check back regularly to discover new content and events over the coming weeks and months, and make the meeting a year-round experience!

Access the Annual Meeting content…