Today’s Top Story
Legislators seek consensus on ACA repeal.
An article in Kaiser Health News reports on a retreat held this week by Republican legislators that in part addressed possible replacement plans for the Affordable Care Act (ACA). The article notes that legislators appeared to agree that timing for a replacement plan could take them through the summer. In addition, it appears likely that there may not be a single ACA replacement, but a series of smaller bills, coupled with budget resolutions, regulatory action, and executive orders. Concepts under discussion included selling health insurance across state lines and capping damages in medical liability suits. A budget resolution passed by both houses of the U.S. Congress had called for work on ACA partial-repeal bills to be completed by Jan. 27, but the deadline was not met. Read more…

Other News

Study: aBMD may not predict bone changes for menopausal women.
Findings from a study published online in the Journal of Bone and Mineral Research suggest that areal bone mineral density (aBMD) may not predict bone changes for women transitioning through menopause. The research team analyzed hip dual-energy X-ray absorptiometry images acquired longitudinally over 14 years for 198 mid-life women who were transitioning through menopause. They observed a 14-year change in bone mineral content (BMC) and bone area, but not aBMD, across tertiles based on baseline bone area-height residuals. The research team found that women with narrow femoral necks showed smaller changes in BMC “but greater increases in bone area compared to women with wide femoral necks who showed greater losses in BMC but without large compensatory increases in bone area.” They note that the finding is “opposite to expectations that periosteal expansion acts to mechanically offset bone loss. Thus, changes in femoral neck structure and mass during menopause vary widely among women and are predicted by baseline external bone size but not aBMD.” Read more…
Read the abstract…

Study: Glucosamine and chondroitin combination therapy may be as effective as placebo for symptomatic knee OA.
According to a study published in the January issue of the journal Arthritis & Rheumatology, combination therapy with chondroitin sulfate (CS) and glucosamine sulfate (GS) may not be superior to placebo for the treatment of symptomatic knee osteoarthritis (OA). The authors conducted a randomized, double-blind, placebo-controlled trial of 164 patients with Kellgren/Lawrence grade 2 or grade 3 radiographic knee OA and moderate-to-severe knee pain. Patients received a 6-month course of treatment consisting of a single, oral, daily dose of placebo or combined treatment with CS (1,200 mg) and GS (1,500 mg). In a modified intent-to-treat population, they found that CS/GS combination therapy was inferior to placebo in the reduction of joint pain, but found no between-group differences in per-protocol completers. Overall, both placebo treatment and CS/GS combination treatment improved to a similar extent the total Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain scores and function WOMAC subscale scores. Read more…
Read the complete study…

CDC report finds residents of rural areas at increased risk of potentially preventable mortality.
Data from the U.S. Centers for Disease Control and Prevention indicate that Americans who live in rural areas may be more likely than urban dwellers to die from potentially preventable causes. The researchers reviewed mortality data from the National Vital Statistics System, and found that residents of rural areas tended to be older and sicker than those who live in urban settings, and have higher rates of cigarette smoking, high blood pressure, and obesity. In addition, rural residents reported less leisure-time physical activity, lower seatbelt use, higher rates of poverty, less access to healthcare, and were less likely to have health insurance. Among other things, the researchers recommend that healthcare providers in rural regions:

  • Engage in safer prescribing of opioids for pain
  • Encourage physical activity and healthy eating to reduce obesity
  • Promote motor vehicle safety
  • Promote smoking cessation

Read more…

Proposed tariff could affect cost of orthopaedic devices.
The Trump administration has suggested imposing a 20 percent tax on imports from Mexico to pay for a wall along the U.S.-Mexico border. A spokesperson for the administration clarified that the suggestion is not an official policy proposal. An article in Modern Healthcare notes that between January 2016 and November 2016, the United States imported more medical, surgical, dental, and veterinarian instruments from Mexico than any other nation—more than $5.4 billion worth, representing 27 percent of all such imports. Mexico is also the fourth-biggest exporter to the United States of orthopaedic devices. Read more…(registration may be required)

CMS webinar will offer advice to small and rural practices on participating in MIPS.
The U.S. Centers for Medicare & Medicaid Services (CMS) will host a webinar to help small, rural, and underserved practices participate in the Merit-Based Incentive Payment System portion of the Quality Payment Program. The presentation will cover eligibility, participation options for 2017, and an overview of the four performance categories. The webinar will be held Wednesday, Feb. 1, 2017, from 1:00 p.m. to 2:15 p.m. ET. Register for the webinar…

Last call: CMS Technical Expert Panel on Hospital Quality Star Ratings on Hospital Compare.
AAOS seeks to nominate members to the CMS Technical Expert Panel on Hospital Quality Star Ratings on Hospital Compare. The Star Rating project is designed to create a picture of current measures publicly reported on the Hospital Compare website so that aspects of quality are presented in a meaningful and accessible way. Panel recommendations and discussion will inform the refinement of this methodology. Applicants for this position must be active members, 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 (10 pages maximum), a 100-word biosketch, a statement of interest (not to exceed two pages) highlighting experience/knowledge relevant to the expertise described above, and a nomination form (available from the email below). All supporting materials must be submitted by Jan. 29, 2017 at 11:59 p.m. (CT), to Kyle Shah at:
Learn more and submit your application…(member login required)