Today’s Top Story
CMS withdraws proposal to require accreditors to publicize findings from facility inspections.
An article on ProPublica notes that, after consideration of public comments, the U.S. Centers for Medicare & Medicaid Services has withdrawn a proposal that would have required private healthcare accreditors to publicly release issues noted during medical facility inspections. The agency had proposed to revise the application and re-application process for accrediting organizations by requiring them to post survey reports and plans of corrections from CMS-approved accreditation programs on their public-facing websites. “CMS is committed to ensuring that patients have the ability to review the findings used to determine that a facility meets the health and safety standards required for Medicare participation,” the agency states. “However, we believe further review, consideration, and refinement of this proposal is necessary to ensure that CMS establishes requirements, consistent with our statutory authority, that will inform patients and continue to support high-quality care.”
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Other News
Study: High cholesterol and LDL levels linked to higher risk of revision for patients undergoing primary arthroscopic rotator cuff repair.
Findings published online in The American Journal of Sports Medicine (AJSM) suggest that moderate and high preoperative total cholesterol and low-density lipoprotein (LDL) levels may be associated with increased risk of revision following primary arthroscopic rotator cuff repair. The authors conducted a retrospective, cohort study of 30,638 patients who underwent arthroscopic rotator cuff repair. Compared to patients with normal cholesterol or LDL levels (based on published standards), they found that the rate of revision rotator cuff surgery was significantly increased among patients who had moderate or high total cholesterol levels or moderate or high LDL levels (follow-up range 6 months to 8 years). However, they found no significant difference in revision rates among patients with normal, moderate, or high triglyceride levels. In addition, among patients with high total cholesterol or high LDL levels, the authors noted that patients without statin use had significantly higher rates of revision surgery.
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Study: Bone mass may be affected by marrow fat changes after weight loss.
Data from a study published online in the Journal of Bone and Mineral Research suggest that blood sugar metabolism and weight loss may affect marrow fat, which, in turn, may affect bone health. The researchers conducted a study of 30 obese female patients to test their hypothesis that marrow fat changes may be associated with bone mineral density (BMD) loss after Roux-en-Y gastric bypass surgery. Preoperatively, patients with higher marrow fat had lower BMD. At 6-month follow-up, patients with diabetes displayed a mean marrow fat change of -6.5 percent, while no significant mean change in marrow fat was seen in patients without diabetes. Overall, patients with greater improvements in hemoglobin A1c had decreases in marrow fat and increases in IGF-1—a potential mediator of the marrow fat-bone relationship—were associated with marrow fat declines.
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Study: Heel-rise height deficit 1 year after Achilles tendon rupture relates to changes in ankle biomechanics.
A study published online in AJSM explores mid-term differences in ankle biomechanics associated with differences in heel-rise height at 1 year following Achilles tendon rupture. The authors conducted a cohort study of 34 patients who, at 1-year follow-up, had either less than 15 percent difference in heel-rise height (n = 17) or greater than 30 percent difference in heel-rise height (n = 17). At mean 6-year follow-up, they found that patients in the >30 percent cohort had significantly greater deficits in ankle kinetics during walking, jogging, and jumping; significantly lower values in heel-rise height and heel-rise work; and significantly larger side-to-side differences in tendon length compared with patients in the <15 percent cohort. The authors write that minimizing tendon elongation and regaining heel-rise height may be important for the long-term recovery of ankle biomechanics, particularly for demanding activities such as jumping.
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Survey: Few patients seek pricing information for health care.
A study published in the August issue of the journal Health Affairs suggests that, despite trends toward an increase in the availability of price data and patient cost sharing, comparatively few patients may seek pricing information. The research team surveyed 2,996 nonelderly adults in the United States who had received medical care during the previous year. They found that only 13 percent of respondents who had some out-of-pocket spending in their last healthcare encounter had sought pricing information prior to receiving care, and just 3 percent had compared costs across providers before receiving care. The research team states that common barriers to price shopping included difficulty obtaining price information and a desire not to disrupt existing provider relationships.
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Pennsylvania.
An article on the Pennsylvania Medical Society website examines a recent decision by the Supreme Court of Pennsylvania that could affect how informed consent is handled in the state. In a 4-3 decision, the court ruled that physicians have a “non-delegable” duty to provide information to a patient sufficient to obtain informed consent. At issue was a suit that depended in part on an informed consent form that was signed after a physician’s assistant answered questions regarding possible surgical complications. The society notes that the decision means “that physicians alone have the duty to provide patients with the sufficient information required to obtain informed consent.”
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Last call: Content Committees.
Aug. 11 is the last day to submit your application for a position on a Content Committee (one member opening—generalist). Content Committees help identify member knowledge gaps across various specialty areas and make recommendations regarding product and program development. Applicants for this position must be active fellows with a generalist orthopaedic focus.
Learn more and submit your application…(member login required)
