Today’s Top StoryU.S. healthcare spending growth slowed in 2016

A report from the U.S. Centers for Medicare & Medicaid Services Office of the Actuary finds that growth in overall healthcare spending in the United States decelerated to 4.3 percent in 2016, following 5.8 percent growth in 2015. The report notes that during 2014 and 2015, the healthcare-spending share of the economy increased 0.5 percent from 17.2 percent in 2013 to 17.7 percent in 2015. Other findings from the report include:

  • private health insurance spending increased 5.1 percent in 2016, compared to 6.9 percent growth in 2015
  • Medicare spending grew 3.6 percent in 2016, compared to 4.8 percent in 2015 and 4.9 percent in 2014
  • Medicaid spending growth increased 3.9 percent in 2016, compared to 11.5 percent in 2014 and 9.5 percent in 2015
  • consumer out-of-pocket spending grew 3.9 percent in 2016, compared to 28 percent growth in 2015

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Other NewsMedPAC finalizes recommendation to replace MIPS

Modern Healthcare reports that the U.S. Medicare Payment Advisory Commission (MedPAC) has finalized a recommendation to repeal and replace the Medicare Merit-based Incentive Payment System (MIPS) in favor of a new voluntary value program in which providers would join a group and be compared to each other on quality of care. The agency criticized the current program, calling it burdensome and ineffective, as it primarily measures how clinicians perform, rather gauging improvements to patient care. The recommendation is expected to be voted on in January 2018.

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FDA announces new guidance documents addressing agency’s role in digital healthThe U.S. Food and Drug Administration (FDA) announced two new draft guidances and one final guidance that address the 21st Century Cures Act and clarify the agency’s role in digital health. The first draft guidance outlines the FDA’s approach to clinical decision support software (CDS), including what types of CDS will no longer be defined as a medical device and therefore not regulated by the agency. The second draft guidance addresses other digital health provisions included in the 21st Century Cures Act and outlines the FDA’s interpretation of the types of software that are no longer considered medical devices. The final guidance establishes common principles for regulators to use in evaluating the safety, effectiveness, and performance of software as a medical device, based on the overall risk of the product.

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Read “Clinical and Patient Decision Support Software” (PDF)…

Read “Changes to Existing Medical Software Policies Resulting from Section 3060 of the 21st Century Cures Act” (PDF)…

Read “Software as a Medical Device: Clinical Evaluation” (PDF)…

Study: COC and COP THA bearings may offer similar long-term outcomesFindings from a study published online in The Journal of Arthroplasty suggest similar long-term survivorship and function for total hip arthroplasty (THA) patients treated with either ceramic on ceramic (COC) or ceramic on polyethylene (COP) bearings. The authors conducted a prospective study of 57 patients (58 hips) with a mean age of 42 years. At minimum 15-year follow-up, they found that three patients died, but had not been revised, and seven patients had been lost to follow-up. Among the remaining patients, they found that five cases from the CoP cohort were revised (four for polyethylene wear and osteolysis), while four from the CoC cohort were revised (one each for head fracture, instability, infection, and trunnionosis). Patients in both groups displayed similar statistically significant improvement in Harris Hip Score and St. Michael’s Score.

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Study: Poverty and education may impact TKA outcomesAccording to a study published online in the journal Arthritis Care & Research, higher patient education level may be associated with improved outcomes for total knee arthroplasty (TKA) for patients living in poorer communities. Members of the research team reviewed institutional registry and U.S. Census Bureau data on 3,970 TKA patients, 2,438 (61 percent) of whom reported attending at least some college. They found that no college was associated with worse Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function at baseline and 2-year follow-up, while living in a poor neighborhood (defined as >20 percent below poverty) was associated with worse WOMAC pain and function at 2 years. Furthermore, the researchers noted that patients without college education living in poor communities had pain scores approximately 10 points worse than those with some college education; in wealthy communities, college was associated with a difference in pain of only 1 point.

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Study: Cigarette smoking linked to increased risk of musculoskeletal injuryData from a study published in the November issue of the journal Medicine & Science in Sports & Exercise suggest that cigarette smoking may increase risk of musculoskeletal injury. The researchers conducted a meta-analysis of 18 studies that looked at musculoskeletal injuries and cigarette smoking among military populations. They found smoking to be a moderate risk factor musculoskeletal injury. In addition, they note that although enlistees are not allowed to smoke during basic training, their risk of injury remains high, suggesting that smokers may remain at increased risk for some time after quitting.

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Your AAOSCall for volunteers: BCBSA expert panel

AAOS seeks to nominate one spine surgeon to a Blue Cross Blue Shield Association (BCBSA) expert panel to provide input into development of quality selection criteria and provider survey. Applicants for this position must be active fellows, candidate members, candidate members osteopathic, candidate member applicants for fellowship, or candidate member applicants for fellowship osteopathic with a practice emphasis in spine. In addition, all applicants must provide the following: an online AAOS CAP application, a current curriculum vitae, and a 100-word biography. All supporting materials must be submitted to Kyle Trivedi by Dec. 17, 2017 at 11:59 p.m. CT, at:

trivedi@aaos.org

Learn more and submit your application…  (member login required)