Today’s Top Story
Study: ScoliScore values are not predictive of curve progression in AIS patients.
Study data published in the Dec. 16 issue of The Journal of Bone & Joint Surgery (JBJS) indicate that ScoliScore values do not differ among patients with adolescent idiopathic scoliosis (AIS) patients regardless of curve progression. When administered in the early stages of AIS development, the ScoliScore saliva test is designed to predict the potential for curve progression in AIS patients. Researchers administered ScolioScore tests to 126 skeletally immature AIS patients (89 percent female; mean age = 12 years) at two institutions between Jan. 1, 2009, and June 21, 2012, and followed the patients until they reached skeletal maturity. The researchers identified two outcome groups: progression and nonprogression. Patients in the progression group either had a Cobb angle >40° or had undergone surgical fusion; patients in the nonprogression group had reached skeletal maturity without curve progression to >40°. The researchers found no significant difference in the mean ScoliScore between patients with and without curve progression (P = 0.706). They also found no significant difference in curve progression between patients with high-risk ScoliScore values and those with low-risk values ((P = 0.399). Read the study…
Other News
GAO: “Vertical consolidation” drives up costs.
A report by the Government Accountability Office (GAO) found that “vertical consolidation”—an arrangement in which a hospital acquires a physician practice and/or has physicians on salary—is linked with more evaluation and management (E/M) visits occurring in a hospital setting. The trend leads to increased costs for Medicare, which pays providers at a higher rate when the same service is performed in a hospital outpatient department (HOPD) compared to a physician’s office. Between 2007 and 2013, the number of vertically consolidated hospitals grew from about 1,400 to 1,700, and the number of vertically consolidated physicians nearly doubled, from 96,000 to 182,000. In 2013, the Medicare payment for a midlevel E/M visit was $51 higher when it took place in a hospital. “Such excess payments are inconsistent with Medicare’s role as an efficient purchaser of health care,” the GAO stated. However, the agency noted, the Centers for Medicare & Medicaid Services (CMS) “lacks the statutory authority to equalize total payment rates between HOPDs and physician offices and achieve Medicare savings.” Read more…
DOJ announces settlement with hospitals over false kyphoplasty billing claims.
The U.S. Department of Justice (DOJ) announced last week that 32 hospitals in 15 states will pay a total of $28 million to settle allegations that they submitted false claims to Medicare regarding kyphoplasty procedures, Reuters reports. According to the DOJ, the hospitals performed the surgeries on an inpatient basis to increase their Medicare billings; the DOJ maintained that the procedures could have been safely performed in many cases on a less-costly outpatient basis. To date, the DOJ has reached similar settlements with more than 130 hospitals totaling approximately $105 million. Read more…
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Study: Low-aerobic fitness in late adolescence is associated with risk of early death.
A study published in the International Journal of Epidemiology suggests that late-adolescent males with low-aerobic fitness are at increased risk of early death. Researchers in Sweden followed 1.3 million males (mean age: 18 years) whose aerobic fitness had been assessed between 1969 and 1996. The mean follow-up was 29 years. Individuals in the highest fifth of aerobic fitness were found to be at lower risk of death from any cause (hazard ratio, 0.49; 95 percent confidence interval, range, 0.47–0.51), compared to those in the lowest fifth. Although aerobic fitness was associated with a reduced risk of death from any cause in normal-weight and overweight individuals, the benefits of aerobic fitness decreased in obese individuals (P < 0.001). In addition, the risk of death from any cause was higher in aerobically fit obese individuals than in unfit normal-weight individuals. Read the abstract…
Study: Tapering of TNF dose in patients with ankylosing spondylitis yields cost savings, equivalent outcomes.
A tailored dose-tapering strategy for anti-tumor necrosis factor (TNF) drugs is clinically equivalent and less costly over 1 year than standard dosing in patients with ankylosing spondylitis (AS) who achieve low disease activity, according to a Czech study published in the Annals of the Rheumatic Diseases. The observational study found that the tapered dosing strategy resulted in annual savings of more than 4,000 euros ($4,337). In the study, 53 patients treated with attempted dose reduction of TNF inhibitors were matched to 83 patients who continued standard doses. “Low-dose regimens may be considered as a ‘maintenance’ strategy after successful ‘induction’ treatment with standard doses of anti-TNF drugs in patients with AS,” the authors wrote. They noted that based on positive experience, physicians at Charles Hospital in Prague were considering careful TNF-dose reduction in AS patients with inactive disease for more than 6 months. The authors advised that patients receiving reduced dosages be closely monitored, because approximately one in five patients required re-escalation of anti-TNF therapy. Read more…
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Illinois.
The Federal Trade Commission (FTC) is seeking to block a proposed merger of Advocate Health Care and NorthShore University HealthSystem, Modern Healthcare reports. The merged entity would consist of 5 acute-care hospital campuses, a children’s hospital, and a large group of employed and affiliated doctors in the Chicago area. The FTC notes that the conglomerate would control more than 50 percent of general acute-care inpatient hospital services in Chicago’s North Shore suburbs, where the systems now operate competing hospitals, and could lead to higher prices. The hospitals contend that insurance companies are the parties with actual pricing power. Advocate chief executive Advocate CEO Jim Skogsbergh emphasized that Advocate and NorthShore’s combined market share in the Chicago area is just 22 percent, whereas insurer Blue Cross and Blue Shield of Illinois has more than 70 percent of the market, making providers in the Chicago area “price takers not price setters.” Read more…
Call for volunteers: Annual Meeting Committee.
Three positions are available on the AAOS Annual Meeting Committee. The Chair Designee position is open to active fellows; applications are due Jan. 2, 2016. The Allied Health Representative Member position is open to active fellows with an interest in and knowledge of allied health education; applications are due Jan. 4, 2016. The Member-at-Large position is open to active fellows (not current members of the Central Program, Exhibits, or Central Instructional Course committees); applications are due Jan. 4, 2016. For more information and to apply…(member login required)
