Today’s Top Story
Prior authorization issues continue to burden many providers.
An article in MedPage Today looks at the issue of prior authorization as discussed at the annual meeting of the Healthcare Information and Management Systems Society. A survey recently conducted by the American Medical Association found that responding medical practices submitted an average of 37 prior authorization requests each week, with an average of 16 hours of physician and staff time required to complete the requests. Overall, 75 percent of respondents found prior authorization to be burdensome, and more than one third reported having staff who work exclusively on prior authorization. At least one healthcare plan has developed an online authorization portal that allows providers to enter their own authorization information, with instant approval notification, and other organizations are working to develop ways to streamline the authorization process.
Read more…(registration may be required)
Other News
Bills introduced to eliminate IPAB.
According to the California Medical Association, several bills have been introduced in both houses of the U.S. Congress to eliminate the Medicare Independent Payment Advisory Board (IPAB). IPAB is a 15-member federal agency called for under the Affordable Care Act, which would be created if Medicare spending growth exceeds certain levels. Cuts proposed by IPAB could be overridden by a three-fifths majority vote of both houses of Congress.
In a letter to sponsors of the proposed bills, the American Association of Orthopaedic Surgeons (AAOS) notes concerns that “the IPAB will function only as a denial-of-care board that will reduce patients’ access to health care just to meet an arbitrary budget. This would be devastating to patients as it could affect quality of care and access to innovative therapies.”
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Study: Lumbar microdiskectomy may often be appropriate for older patients.
A research letter published online in the journal JAMA Surgery compares patient-reported outcomes for older and younger patients following lumbar microdiskectomy. Researchers in Norway reviewed registry data on 5,575 patients who underwent lumbar microdiskectomy, 380 of whom were aged 65 years or older at the time of surgery. They found that all patients displayed significant improvement, and there were no age-related differences in terms of improved quality of life or leg pain after surgery. However, the researchers note that patients aged 65 years and older were more likely to experience minor complications, both in the hospital and within 3 months of discharge.
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Read the abstract…
Study: Expert panel issues recommendation against use of LIPUS for fracture healing.
A recommendation published in the journal The BMJ recommends against the use of low-intensity pulsed ultrasound (LIPUS) to help speed fracture healing. An expert panel reviewed evidence from randomized trials that assessed LIPUS versus sham device or no device, and unanimously agreed to issue a strong recommendation against LIPUS for patients with any bone fractures or osteotomy. “LIPUS does not represent an efficient use of health resources for individuals or health funders,” they write, “given its lack of benefit on outcomes important to patients and its purchasing costs. Healthcare organizations that currently pay for LIPUS may reasonably choose to stop reimbursements based on best current evidence and our strong recommendation against LIPUS.”
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Read the abstract…
An AAOS Clinical Practice Guideline on Treatment of Distal Radius Fractures states that “no long term or permanent benefit related to a validated outcome measure was demonstrated with the use of low-intensity ultrasound,” based on limited evidence.
Read the AAOS CPG…
Maine.
An article in HealthLeaders Media looks at the issue of Medicare and commercial accountable care organization (ACO) models in Maine and offers recommendations for successful implementation. A spokesperson for one ACO states that commercial accountable care contracts often offer improved financial incentives compared to the Medicare Shared Savings Program (MSSP). However, she notes that ACO leadership must be prepared for tough contract negotiations with commercial payers.
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March AAOS Now is online now and in your mailbox soon!
AAOS members will soon receive the print edition of the March issue of AAOS Now, but the online edition is already available on the AAOS Now website. This month’s issue includes an article about things to do in San Diego, a look at new healthcare reform efforts in Washington, D.C., an examination of near infrared spectroscopy in the diagnosis of compartment syndrome, and much more!
Read more…
Read “‘America’s Finest City’ Welcomes AAOS!”…
Read “Trump Administration, Congress Take Steps on Healthcare Reform”…
Read “Study Describes “Game Changer” Technology for Diagnosing Compartment Syndrome”…
Presentation and discussion on proposed hip and knee surgeon rating system to be held at AAOS Annual Meeting.
Two representatives from U.S. News & World Report will present plans for and seek input on a proposed methodology to create a new rating system for hip and knee surgeons. The presentation will be followed by a question and answer session and an open discussion period. Participation is free, but limited to hip and knee surgeons only. The event will be held at 10:00 a.m., Wednesday, March 15, at the AAOS Annual Meeting in San Diego. To participate, please register by Feb. 15, 2017.
Register online…
