Today’s Top Story
Physicians have until Feb. 28 to appeal improper PQRS penalties.
Physicians have until Feb. 28 to file informal appeals if they believe they have received an incorrect Physician Quality Reporting System (PQRS) payment penalty. The U.S. Centers for Medicare & Medicaid Services (CMS) has made available an online tool to assist with this process. The PQRS Look Up portal accesses the same database as the CMS Help Desk, and can be used to verify whether a physician is subject to the 2015 PQRS payment adjustment, or if he or she should have received a 2013 PQRS incentive. To access the site, physicians will need their Tax Identification Number (TIN) or TIN/National Provider Identifier combination.  Read more…
Access the portal…

Other News

Study: Memory prompt may help reduce opioid prescribing after hand surgery.
Findings from a study published online in The Journal of Hand Surgery suggest that an educational approach for physicians may help reduce the size of postoperative opioid prescriptions. The researchers developed an educational assist device (the pink card) to serve as a memory prompt for physicians when they conducted one of four common hand surgery procedures. The pink card was given to physicians, midlevel practitioners, and trainees. After implementation of the pink card, average postoperative prescription size decreased for all four case types by 15 percent to 48 percent, reaching statistical significance for two procedures. In all cases, variability in prescription sizes decreased, and the researchers noted a trend toward a decreasing number of prescription refills over the course of the study. There was no evidence that patients were obtaining refills from other sources within the research team’s multigroup practice.  Read the abstract…

Study: High-impact exercise program may help improve patellar cartilage quality and physical function among older women with knee OA.
According to a study published online in the journal Medicine & Science in Sports & Exercise, implementation of a progressively implemented high-impact exercise program may be linked to improved patellar cartilage quality and physical function in postmenopausal women with mild knee osteoarthritis (OA). The authors conducted a randomized study of 80 postmenopausal women (mean age 58 years) who underwent either a supervised progressive impact exercise program three times a week for 12 months (n = 40) or to non-intervention (n = 40). Post-intervention, they found that, on MRI, the full-thickness patellar cartilage T2 values had medium size effect, and the change difference was 7 percent greater in the exercise group compared to the control group. In the deep half of tissue, the change difference was 8 percent greater in the exercise group compared to controls. In addition, significant medium size T2 effects in favor of the exercise group were found in the total lateral segment, lateral deep, and lateral superficial zone. Finally, extension force increased by 11 percent more and maximal aerobic capacity by 4 percent more in the exercise group compared to patients in the control group.  Read more…
Read the abstract…

House bill would clarify medical liability for team physicians.
A bill has been introduced in the U.S. House of Representatives that would, if enacted, provide limited medical liability protection for sports medicine providers and athletic trainers who provide care to an athlete or members of an athletic team during sporting events in another state. Supporters of the bill state that it clarifies current ambiguity regarding a sports medicine professional’s ability to obtain coverage from his or her medical liability insurance carrier in the event of a lawsuit arising from care delivered while traveling out of state. A Senate version of the bill is expected to be introduced next week. Further information will be available on Feb. 24 on the American Association of Orthopaedic Surgeons (AAOS) office of government relations (OGR) website and in the Mar. 3 issue of AAOS Advocacy Now.  Read more…
Visit the AAOS OGR website…
View more information about the bill…

Is race a factor in health care?
The Feb. 18 issue of The New England Journal of Medicine carries two perspective pieces that examine the effect of race on medical treatment. The first, written by the health commissioner of New York City, notes that the rate of premature death in New York City is 50 percent higher among black men than among white men—a gap that is “not accounted for entirely, or even mostly, by violence,” but “reflects dramatic disparities in many health outcomes, including cardiovascular disease, cancer, and HIV.” The second looks at possible systemic biases in academic medical centers, noting the following:

  • Evidence suggests that some healthcare providers may hold stereotypes based on patient race that can influence clinical decisions.
  • Despite physicians’ and medical centers’ best intentions of being equitable, black–white disparities persist in patient outcomes, medical education, and faculty recruitment.

Read “#BlackLivesMatter — A Challenge to the Medical and Public Health Communities”…
Read “Bias, Black Lives, and Academic Medicine”…

More than 85 percent of current orthopaedic residents are male.
The Association of American Medical Colleges (AAMC) has released its AAMC Report on Residents (2015)—an online collection of data tables that provide information on certain characteristics of residency applicants and residents, as well as information on the outcomes of residents. The analysis shows 3,428 currently active residents in orthopaedic surgery in U.S. and Canadian medical schools. Of those, 2,955 (86.2 percent) are male, and 473 (13.8 percent) are female. AMA Wire notes that the data reflect results of a 2013 study that found women to be substantially underrepresented in orthopaedics, neurosurgery, urology, general surgery, and radiology.  Read more…
Read the executive summary (PDF)…
View the complete report…

Pennsylvania.
A research brief from the Pennsylvania Health Care Cost Containment Council finds that so-called “super-utilizers”—patients with five or more admissions to a general acute care hospital per year, often for chronic illnesses—accounted for $761 million of Medicare and Medicaid expenditures for inpatient stays in in that state during FY 2014. Among the findings:

  • 14 percent—$545 million—of Medicare fee-for-service payments for inpatient stays were for super-utilizers
  • 17 percent—$216 million—of Medicaid payments (including both fee for service and managed care) for inpatient stays were for super-utilizers

The authors of the report state that the evidence suggests that, although super-utilizers represent a relatively small percent of patients, they tend to have longer hospital stays and account for a disproportionate use of healthcare resources.  Read more…
Read the research brief (PDF)…

Call for volunteers: PCPI Care Coordination and Patient Engagement Expert Work Groups.
CMS has contracted with the American Medical Association Physician Consortium for Performance Improvement (PCPI), The Lewin Group, and Mathematica Policy Research to develop, specify, and maintain clinical quality measures that may be used for reporting by eligible professionals using certified electronic health record (EHR) systems for CMS quality programs. AAOS seeks to nominate members to the PCPI Care Coordination Expert Work Group and the PCPI Patient Engagement Expert Work Group. Applicants for these positions must be active fellows, candidate members, candidate members osteopathic, candidate member applicants for fellowship, or candidate member applicants for fellowship osteopathic. In addition, all applicants must provide the following: an online AAOS CAP application, a current curriculum vitae, a 100-word biosketch, and a letter of interest highlighting his or her expertise in the subject area and which expert work group he or she is applying. All supporting materials must be submitted by Feb. 25, 2015 at 11:59 p.m. CT, to Kyle Shah, at shah@aaos.org.
Learn more and submit your application…(member login required)