Today’s Top Story

Today’s Top Story
1. MedPAC recommends freezing reimbursement to ASCs, other institutions during 2016.
Modern Healthcare reports that the Medicare Payment Advisory Commission (MedPAC) has voted to recommend that the U.S. Congress freeze Medicare reimbursements for ambulatory surgical centers (ASCs), dialysis, hospices, and long-term care hospitals at current rates during 2016. Panel members also proposed a package of recommendations from the agency’s March 2014 report, including increasing payment rates for acute-care hospital inpatient and outpatient prospective-payment systems in 2016 by 3.25 percent, and creating site-neutral payment for certain services offered in both hospital outpatient departments and physician offices. MedPAC projects that the proposals would have little to no impact on access to services, but would save Medicare more than $1 billion. Read more…
Access the briefs and transcriptions from the Jan. 15–16 MedPAC meeting…

Other News
2. Insurer report finds wide variation in costs of TKA and THA.
A report released by Blue Cross Blue Shield Association finds that costs for total knee and total hip arthroplasty (TKA and THA) procedures vary widely across the United States, and even within the same market. The researchers analyzed 3 years of independent claims data to assess cost variations across in 64 markets. They found that the average typical cost (without complications) for a TKA was $31,124, ranging from $11,317 in Montgomery, Ala., to $69,654 in New York City. Within the Dallas region alone, TKA costs ranged from $16,772 to $61,585, depending on the hospital. The researchers noted similar trends for THA, which averaged $30,124 across the United States, ranging from $11,327 in Birmingham, Ala., to $73,987 in Boston. Boston also displayed the greatest variance in cost of THA within a market, with a low of $17,910.  Read more…
Read the complete report (PDF)…

3. Studies look at HAI reduction initiatives.
A pair of recently published studies look at the efficacy of programs to reduce the incidence of healthcare-associated infections (HAIs). The first, published in the Jan. 1 issue of the American Journal of Infection Control, looks at 5 years of Medicare data combined with HAI rates and cost and quality of life estimates drawn from published studies, and concludes that multifaceted HAI prevention programs are cost-effective. “The welfare benefits implied by the advantageous incremental cost-effectiveness ratios would be lost if the investments were suspended,” the authors write.
Read the complete study…
The second study, published in the Jan. 20 issue of The Journal of the American Medical Association, questions whether daily bathing of critically ill patients with chlorhexidine may reduce the incidence of HAIs. The researchers conducted a pragmatic, cluster randomized, crossover study of 9,340 patients admitted to 5 adult intensive care units of a single tertiary medical center, and found no significant difference in HAI incidence between groups bathed with chlorhexidine-impregnated cloths and those bathed with nonantimicrobial cloths.
Read the complete study…

4. Study: Antibiotic coating may discourage biofilm formation.
Findings published online in the journal Clinical Orthopaedics and Related Research suggest that use of an antibiotic implant coating may discourage the formation of biofilm on orthopaedic biomaterials. The authors used a mix of phosphatidylcholine with 25 percent amikacin, 25 percent vancomycin, or a combination of 12.5 percent of both, to coat titanium and stainless steel wires inoculated withStaphylococcus aureus and Pseudomonas aeruginosa in a mouse model. They found that antibiotic-loaded coatings reduced attachment of bacteria to wires in vivo. The authors write that future evaluations should include orthopaedic preclinical models to confirm therapeutic efficacy.
Read the abstract…

5. Endocrine Society releases CPG on pharmacological management of obesity.
The Endocrine Society has released a clinical practice guideline (CPG) on pharmacological management of obesity. The authors conclude that knowledgeable prescribing of medications can aid in the prevention and management of obesity among patients with favorable weight profiles. Among the recommendations:

  • That diet, exercise, and behavioral modification be included in all obesity management approaches for body mass index (BMI) ≥ 25 kg/m2, and that other tools such as pharmacotherapy and bariatric surgery be used as adjuncts to behavioral modification to reduce food intake and increase physical activity among appropriate patients.
  • A recommendation for weight-losing and weight-neutral medications as first- and second-line agents in the management of a patient with type-2 diabetes who is overweight or obese.
  • A recommendation against the off-label use of medications approved for other disease states for the sole purpose of producing weight loss.

Read the compete CPG (PDF)…

6. Republican response to State of the Union includes promise to repeal ACA.
The Hill reports that, in their response to the State of the Union Address, Republican lawmakers vowed to repeal and replace the Affordable Care Act (ACA), stating that it has resulted in canceled healthcare plans, increased premiums, and “hurt […] hardworking families.” For his part, President Obama stated during the address that he would veto any bill that might “put the security of families at risk by taking away their health insurance.” The publication notes that Republicans have so far fallen short of agreeing on a replacement plan for the ACA.  Read more…

7. Massachusetts.
An article on Kaiser Health News profiles a Massachusetts medical liability law that mandates that people give healthcare providers a 6-month notice if they intend to sue. Under the law, providers are given 150 days to respond. The writer notes that such “communication and resolution” programs can offer faster and more acceptable resolutions to all parties, compared to the traditional but adversarial “deny and defend” approach.  Read more…

8. Call for volunteers: Education Enhancement Fund Governance Committee.
Feb. 9 is the last day to submit your application for a position on the Education Enhancement Fund Governance Committee (one member opening). This committee serves as the governing body of the new AAOS Education Enhancement Fund, which was established in late 2010 to raise funds to maintain, expand, and enhance AAOS education programs. Applicants for this committee must be active members, emeritus fellows, or candidate members with experience and knowledge of fund raising.
Learn more and submit your application…(member login required)