Today’s Top Story
Study: Use of CT among pediatric patients may be falling.
A study published online in the journal Pediatrics looks at trends in the use of computed tomography (CT) scans among pediatric patients. The research team conducted a multicenter, cross-sectional study of children admitted to 33 pediatric tertiary-care hospitals from Jan. 1, 2004, through Dec. 31, 2012. They found that across 10 All-Patient Refined Diagnosis Related Groups (APR-DRGs), the number of children imaged with any modality increased over the course of the study, but there was an overall decline in the use of CT. For all APR-DRGs except seizure and infections of upper respiratory tract, the decrease in CT was associated with a significant rise in an alternative imaging modality. Read more…
Read the abstract…
Other News
Court ruling could have implications for physician interactions with insurance networks.
According to AMA Wire, a decision in a recent court case could set a precedent in allowing insurers to terminate physicians from their networks based on a dispute of the necessity of medical services provided. In the relevant case, healthcare providers sued an insurer after they were terminated following a dispute over provided medical services. The company stated that the services were outside its coverage policies, but the physicians argued that, as a result of patients’ assignment of benefits agreements, they should be considered plan beneficiaries under the Employee Retirement Income Security Act (ERISA). ERISA prohibits discrimination against beneficiaries who exercise rights made available under employee benefit plans. Because the plaintiffs were not seeking payment, the court ruled that ERISA did not apply. The healthcare providers in the case were supported by the Medical Society of the State of New York and the Litigation Center of the American Medical Association and State Medical Societies. Read more…
Study: Leukocyte esterase may not be a reliable marker for PJI in shoulder.
Data from a study published in the September issue of the Journal of Shoulder and Elbow Surgery suggest that leukocyte esterase (LE) may be an unreliable marker for the diagnosis of shoulder periprosthetic joint infection (PJI). The authors conducted a prospective study of 45 primary and 40 revision shoulder arthroplasties. They found that, of 5 primaries with positive tissue cultures, only 1 was positive for LE. Similarly, of 16 revisions with positive cultures, 4 were positive for LE. Among revision surgeries overall, LE had sensitivity of 25 percent and specificity of 75 percent to predict positive cultures. Read more…
Study: Do surgeons sometimes debride too much muscle?
A study published online in the Journal of Orthopaedic Trauma examines the possibility that surgeons may occasionally debride viable muscle. The researchers conducted a blinded, prospective study of 36 biopsies collected from 20 patients who underwent debridement for open fracture, compartment syndrome, infection, or crush injury. Based on surgeon impressions using the “four Cs” system (muscle color, consistency, contractility, and capacity to bleed), 25 specimens were considered to be dead muscle, 10 borderline, and one healthy. However, a pathologic analysis of the 35 specimens considered by the surgeon to be dead or borderline muscle demonstrated normal muscle or mild interstitial inflammation in 21 specimens. “Although the fate of the debrided muscle remains unclear if left in situ,” the researchers write, “these results raise questions regarding current practices, including the possibility that surgeons are debriding potentially viable muscle.” Read the abstract…
CMS to hold question and answer session about 2015 PQRS reporting.
The U.S. Centers for Medicare & Medicaid Services (CMS) has announced a Virtual Office Hours Session regarding satisfactory reporting under the 2015 Physician Quality Reporting System (PQRS) to avoid payment adjustment under the 2017 PQRS. The session will take place Sept. 1, 2015, from 2 p.m. to 3 p.m. ET. CMS states that only a limited number of participants will be allowed to register, and asks that—due to limited space—multiple attendees from one company or practice register only once, and attend as a group if possible. Register to participate…
Learn more about the PQRS…
AHRQ director makes case for continued funding.
The Journal of the American Medical Association has published an online interview with Richard Kronick, PhD, director of the U.S. Agency for Healthcare Research and Quality (AHRQ). Critics of AHRQ contend that the agency duplicates comparative effectiveness research efforts by the National Institutes of Health or the Patient-Centered Outcomes Research Institute, and some in the U.S. Congress have proposed eliminating funding for the agency. Dr. Kronick explains the AHRQ mandate and how it differs from other federal agencies. The AAOS is among 140 other groups that have signed a letter to oppose proposed cuts to the AHRQ. Read more…
Does value-based payment equal lower revenues?
An article in the July/August 2015 issue of HealthLeaders magazine argues that a move toward value-based reimbursement need not negatively affect revenue. The writer profiles two health systems that have are undergoing successful transitions, including one that began a shift to value-based pay in 1995, and another that has seen revenue hold steady even though value-based reimbursement now accounts for 22 percent of the system’s revenues. Read more…
Call for volunteers: Orthopaedic PAC.
Aug. 31 is the last day to submit your application for treasurer of the Political Action Committee (PAC) of the American Association of Orthopaedic Surgeons (AAOS). The PAC reports to the chair of the AAOS Council on Advocacy, and is responsible for oversight over all activities relating to political fundraising and financial support for candidates for federal office. Applicants for this position must be active fellows, United States citizens, possess specific knowledge of the many research and health policy positions of the AAOS, have experience interacting with federal officials, and have no conflicts of interest or leadership role in any other state medical society or state orthopaedic society PAC. Learn more and submit your application…(member login required)