Today’s Top Story
Study: Intraoperative PRP may not reduce risk of postoperative infection or delayed wound healing.
Data from a study published online in the journal Foot & Ankle International suggest that intraoperative application of platelet-rich plasma (PRP) may not reduce the likelihood of postoperative infection or delayed wound healing (DWH). The authors conducted a prospective, randomized trial of 500 patients undergoing foot or ankle surgery; patients were randomized to receive intraoperative PRP (applied to operative field) and platelet-poor plasma at closing (PPP, on the sutured skin) or to serve as controls. Of the 250 patients in the control group, 70 had blood drawn and PRP prepared for later assay of growth factors. Deep surgical site infections were noted in two patients in the experimental cohort and in one patient in the control cohort, while DWH was noted in 17 patients in the experimental group and in 17 patients in the control group. Read the abstract…
Other News
Study: Best evidence does not support efficacy of HA for patients with knee OA.
Findings published in the Dec. 16 issue of The Journal of Bone & Joint Surgery suggest that when only the best-quality evidence is considered, viscosupplementation with hyaluronic acid (HA) injection may offer little clinical benefit compared to placebo for patients with knee osteoarthritis (OA). The researchers conducted a “best-evidence” systematic review and meta-analysis of 19 trials. In a meta-analysis of only double-blinded, sham-controlled trials of at least 60 patients, the researchers found no clinically important differences of HA treatment over placebo. When all literature was added to the analysis, the overall effect was greater, but biased toward stronger treatment effects due to the influence of non-blinded or improperly blinded trials. Read the abstract…
Read the AAOS Clinical Practice Guideline (CPG) on Treatment of Osteoarthritis of the Knee (2nd edition)…
Study: Number of adults with access to health care increased over 18-month period.
A study published online in the journal Health Affairs finds that the number of nonelderly U.S. adults with a connection to the healthcare system rose between September 2013 and March 2015. The research team drew data from the Health Reform Monitoring Survey to assess changes in access and affordability from the period just prior to the first open enrollment period for Affordable Care Act (ACA) marketplaces to just after the end of the second open enrollment period. They found a 5.2 percent increase in access to healthcare for low-income adults targeted by the ACA Medicaid expansion provision, and an overall increase in access of 3.4 percent for all nonelderly adults. Read more…
Read the abstract…
CMS expanding bundled payment systems to address value and quality.
An article published in the Dec. 17 issue of The Journal of the American Medical Association looks at the issue of Medicare bundled payment systems. The writers note that more than 20 percent of Medicare fee-for-service payments are made through alternative payment models (APMs), and the U.S. Centers for Medicare & Medicaid Services (CMS) has set goals of increasing that level to 30 percent by 2016 and 50 percent by 2018. The CMS Innovation Center operates three bundled payment models: the Comprehensive Care for Joint Replacement (CJR) Model, the Bundled Payments for Care Improvement, and the Oncology Care Model. The authors note that these models differ in terms of the components of the bundled payment, but share a core principle holding a single organization accountable for most of the care a patient receives during the episode. Read more…
Health system announces plans to open medical school without academic partner.
Kaiser Permanente has announced plans to open its own school of medicine, which the organization claims will “redesign physician education around strategic pillars that include providing high-quality care beyond traditional medical settings, acknowledging the central importance of collaboration and teamwork to inform treatment decisions, and addressing disparities in health.” According to The New York Times, the health system already trains about 600 medical residents in its own program, and several thousand more complete a portion of their training there each year. But one expert noted that the medical school, which is expected to open in fall 2019, would be one of the first run by an integrated health system without an academic partner. Read more…
Read more in The New York Times…
Florida.
HealthLeaders Media reports that a federal appeals court has again upheld a Florida law that restricts physicians and other healthcare providers from asking questions and recording information about patients’ gun ownership. The three-judge panel has issued three separate 2-1 rulings upholding the law, which has been opposed by medical groups, including the American Academy of Pediatrics, the American College of Physicians, and the American Academy of Family Physicians. In the most recent ruling, the majority judges write that the law “codifies the commonsense conclusion that good medical care does not require inquiry or record-keeping regarding firearms when unnecessary to a patient’s care—especially not when that inquiry or record-keeping constitutes such a substantial intrusion upon patient privacy—and that good medical care never requires the discrimination or harassment of firearms owners.” The dissenting judge responds that the law “does not survive First Amendment scrutiny” but declined to write a third dissent responding to the Majority’s evolving rationale. Read more…
Public comment requested for proposed AAOS CPG on Management of Carpal Tunnel Syndrome.
The AAOS Clinical Practice Guideline (CPG) on the Management of Carpal Tunnel Syndrome has completed peer review and is now open for public commentary. AAOS will accept comments on the proposed guideline until Jan. 18, 2016. Read the instructions, with links to supporting documents (PDF)…
Call for volunteers: Coding, Coverage and Reimbursement Committee.
Jan. 3 is the last day to submit your application for chair of the Coding, Coverage and Reimbursement Committee. The Coding, Coverage and Reimbursement Committee reports to the Council on Advocacy, and monitors and makes recommendations regarding Medicare payment and coverage policy issues. Applicants for this position must be active fellows with extensive experience in the area of coding and reimbursement processes. Learn more and submit your application…(member login required)
