Today’s Top Story
CMS issues proposed rule to update methodology used to measure ACO performance.
The U.S. Centers for Medicare & Medicaid Services (CMS) has released a proposed rule to update the methodology used to measure the performance of accountable care organizations (ACOs) in the Medicare Shared Savings Program. Under the proposal, CMS would modify the process for resetting the benchmarks used to determine ACO performance for ACOs renewing their participation agreements for a second or subsequent agreement period. Among other things, the proposal includes:

  • Using regional, rather than national, spending growth trends when establishing and updating an ACO’s rebased benchmark.
  • Giving ACOs time to prepare for benchmarks that incorporate regional expenditures by using a phased-in approach to implementation.
  • Streamlining the methodology for adjusting an ACO’s benchmark when its composition changes.
  • Clarifying the timeline and other criteria for reopening determinations of ACO shared savings and shared losses for good cause or fraud or similar fault.

CMS states that the proposed rule will be open to a 60-day comment period. Read more…
View the CMS fact sheet…
Read the proposed rule…

Other News

Study: Small number of physicians account for disproportionate number of paid medical liability claims.
Findings published in the Jan. 28 issue of The New England Journal of Medicine suggest that a small number of physicians may account for a disproportionately large number of paid medical liability claims. The researchers analyzed data from the National Practitioner Data Bank on 66,426 claims paid against 54,099 physicians. Among physicians with paid claims, they found that 84 percent had incurred only one during the 2005-2014 study period, while 16 percent had at least two paid claims (accounting for 32 percent of claims), and 4 percent had at least three paid claims (accounting for 12 percent of claims). After adjustment, they found that the risk of recurrence increased with the number of previous paid claims. Overall, about 1 percent of all physicians accounted for 32 percent of all paid medical liability claims during the study period. Read more…
Read the abstract…

Study: Small study finds low rates of linear and volumetric wear for single, uncemented acetabular component with XLPE.
A study published in the February issue of the journal Clinical Orthopaedics and Related Research examines long-term outcomes of one uncemented acetabular component design using highly crosslinked polyethylene (XLPE). The research team evaluated a cohort of 72 patients (84 hips). At mean 11-year follow-up (range: 10 to 14 years), they found that the median linear wear rate as 0.024 mm/year and the median volumetric wear rate was 12.19 mm/year. They noted no association between femoral head size and linear wear rate. However, 36-mm and 40-mm femoral heads displayed higher volumetric wear than did 26-mm heads, 28-mm heads, and 32-mm heads. The research team reports that small osteolytic lesions were noted in 12 hips (14 percent), but based on the numbers available, they found no association with head size or volumetric wear rates. Read the abstract…

Study: Is exercise combined with education a reasonable approach to preventing episodes of LBP?
Data from a study published online in the journal JAMA Internal Medicine suggest that exercise alone or in combination with education may be effective for preventing low back pain (LBP). The authors reviewed data from 21 randomized clinical trials covering 30,850 unique participants. They noted moderate-quality evidence that exercise combined with education may reduce the risk of an episode of LBP. For education alone, the authors found moderate- to very low-quality evidence of no effect on LBP or sick leave. They noted low- to very low-quality evidence that back belts do not reduce the risk of LBP episodes or sick leave, and low-quality evidence of no protective effect of shoe insoles on LBP. Read more…
Read the abstract…

New Jersey.
The New Jersey Law Journal reports that a superior court judge in New Jersey has ruled that defendants in a medical liability case may not rely on the Affordable Care Act (ACA) to limit the claim for future medical expenses. At issue is a case in which the parents of a child born with cerebral palsy filed a medical liability suit. The defendants argued that a jury should be told that the ACA will cover many of the child’s future care expenses. However, the judge rejected that argument, writing that with more than 50 congressional votes to repeal the ACA and potential policy shifts in the wake of upcoming federal elections, the “longevity of the ACA is overwhelmingly called into question…” Read more…(registration may be required)

Apply now for the 2016 AAOS/OREF/ORS Clinician Scholar Career Development Program.
March 31 is the last day to submit your application to participate in the Clinician Scholar Career Development Program (CSCDP). The program is a joint project of AAOS, the Orthopaedic Research and Education Foundation (OREF), and the Orthopaedic Research Society (ORS). CSCDP seeks applicants in years PGY2 to PGY5 of orthopaedic residency, fellows, and junior faculty through year 3 who have the potential and desire to become orthopaedic clinician scholars (scientists and investigators). Up to 15 applicants will be selected to participate in the 1.5-day training workshop, with up to 10 additional participants sponsored by orthopaedic specialty societies. The 2016 AAOS/OREF/ORS CSCDP will take place Sept. 15-17, 2016, in Rosemont, Ill. Please submit applications, along with curriculum vitae and a letter of support, by 11:59 PM CT on March 31, 2016 to: csdp@aaos.org
Learn more and submit your application…

Help build a safe and accessible playground in Orlando!
In 2000, hundreds of orthopaedic surgeons, allied health and industry partners, and community volunteers first joined forces with the AAOS to give back to the communities we serve by helping construct a safe and accessible playground so that children with and without disabilities could play together. Join us on Tuesday, March 1, 2016—as the Academy returns to the city where it all began—to help construct its 17th annual volunteer playground build. Enjoy great music, food and fun as you help to assemble playground equipment under the direction of seasoned project managers. No experience is necessary! Buses will run between the Orange County Convention Center and the build site from 7:30 a.m. to 2:30 p.m., and lunch will be provided at the location. Learn more and register to participate…

Call for volunteers: RAND Global Payments for Post-Operative Care Advisory Panel.
AAOS seeks to nominate two members to a Global Payments for Post-Operative Care Advisory Panel conducted by the RAND Corporation. The RAND Corporation is assisting CMS in determining how to best collect visit data through reporting on claims and other data collection models. Applicants for this position must be active fellows, candidate members, candidate member applicants for fellowship, candidate members osteopathic, candidate member applicants for fellowship osteopathic, or resident members who have not been involved with the AMA CPT Editorial Panel, the AMA RUC committees, or payment policy. 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. All supporting materials must be submitted by Sunday, Feb. 7, 2016 at 11:59 p.m. CT, to Kyle Shah, at: shah@aaos.org
Learn more and submit your application…(member login required)