Today’s Top Story
President signs law that requires CMS to grant blanket hardship exemptions from 2015 MU penalties to providers who request them.
President Obama has signed into law the Patient Access and Medicare Protection Act, which includes a provision requiring the U.S. Centers for Medicare & Medicaid Services (CMS) to grant blanket hardship exemptions from 2015 meaningful use (MU) penalties to all providers who request such exemptions. Hardship applications will be accepted until March 15, 2016. The legislation grants CMS the authority to process hardship exemption requests through a more streamlined process. The American Association of Orthopaedic Surgeons had previously expressed concern about the ability of providers to meet MU requirements, particularly since CMS did not release the final rule, which required 90 continuous reporting days, until Oct. 1. Taking advantage of the hardship exemption may help providers avoid an associated 3 percent Medicare payment reductionfor 2017. Read more…
Read more in Advocacy Now…

Other News

Study: Alternative bearings or modularity may not be linked to decreased revision rates after 5 years.
Findings from a study published in the December issue of the journal Clinical Orthopaedics and Related Research suggest that use of alternative bearings or modularity have not resulted in decreased revision rates for total hip arthroplasty (THA) after 5 years. The researchers conducted a systematic review of 32 studies and 5 registry reports on metal-on-metal implants, 19 studies and 5 registry reports on ceramic-on-ceramic implants, and 20 studies and 1 registry report on modular stem designs. They excluded metal-on-ceramic and ceramic-on-metal implants from evaluation due to insufficient data, and did not evaluate monoblock acetabular designs due to their inclusion in another recent systematic review. The researchers found no published evidence that alternative bearings (either metal-on-metal or ceramic-on-ceramic) were associated with decreased revision rates after THA. However, they noted that registry data demonstrate that large head metal-on-metal implants had lower 7- to 10-year survivorship compared to standard bearings, and that modular exchangeable femoral neck implants had a lower 10-year survival rate in both literature reviews and in registry data compared with combined registry primary THA implant survivorship. Read the abstract…

Study: 4 Cs may not correlate with muscle viability.
Data from a study published in the January issue of the Journal of Orthopaedic Trauma suggest that the so-called “4 Cs” (muscle color, consistency, contractility, and capacity to bleed) may not correlate with histologic findings regarding muscle viability when débridement is performed. The authors collected 36 biopsies from 20 patients who had undergone débridement for open fracture (81 percent), compartment syndrome (11 percent), infection (5 percent), or crush injury (3 percent). Surgeons graded the biopsies using the 4 Cs and provided their overall impression as healthy, borderline, or dead, and a blinded pathologic analysis was performed on each specimen. The authors note that surgeons evaluated dead muscle in 25 specimens, borderline in 10, and healthy in 1. However, a pathologic analysis of the 35 specimens considered by surgeons to be dead or borderline muscle demonstrated normal muscle or mild interstitial inflammation in 21 specimens (60 percent). In 72 percent of specimens, the treating surgeon’s gross assessment differed from the histopathologic appearance. The authors write that, although the fate of the débrided muscle remained unclear if left in situ, the results suggest that surgeons may sometimes débride potentially viable muscle. Read the abstract…

North Carolina.
An article published in HealthLeaders Media looks at a decision by Blue Cross Blue Shield of North Carolina to publicly publish pricing information for specific procedures and specific sites of care. A representative of one healthcare system states that the information has not had a material impact on his organization, and that recurring themes from patients are that they don’t understand how to interpret the information, that the information is confusing, and that it does not seem particularly relevant. Read more…

Public comment requested for proposed AAOS CPG on Management of Carpal Tunnel Syndrome.
The AAOS Clinical Practice Guideline (CPG) on the Management of Carpal Tunnel Syndrome has completed peer review and is now open for public commentary. AAOS will accept comments on the proposed guideline until Jan. 18, 2016. Read the instructions, with links to supporting documents (PDF)…

Register now to attend the 2016 AAOS Annual Meeting; free registration ends Thursday, Jan. 21!
AAOS members can take advantage of free advance registration and lower course fees when they register for the 2016 Annual Meeting by Thursday, Jan. 21. The 2016 AAOS Annual Meeting features an array of new learning formats and a variety of clinical and scientific topics. Among other things, this year’s meeting includes the following:

  • 32 symposia
  • 923 paper presentations
  • 576 posters
  • 88 scientific exhibits
  • Orthopaedic Video Theater with more than 80 videos
  • Specialty Day, featuring full programs by orthopaedic specialty societies
  • Electronic Skills Presentations in the newly redesigned Technology Theater

Read more…
Register for the AAOS Annual Meeting…

January AAOS Now is online now and in your mailbox soon!
AAOS members will soon receive the print edition of the January issue of AAOS Now, but the online edition is already available on the AAOS Now website. This month’s issue includes a look at finalized plans for the CMS Comprehensive Care for Joint Replacement bundled payment model; an article from AAOS Now editor-in-chief Eeric Truumees, MD, on challenges and changes physicians are expected to face during the coming year; an examination of the new AAOS Clinical Practice Guideline (CPG) on Surgical Management of Osteoarthritis of the Knee, and much more! Read more…
Read “CMS Finalizes Mandatory Bundled Payment Model”…
Read ” Change Accelerating in 2016″…
Read “Evidence Bolsters Recommendations in New CPG”…

Call for volunteers: Members needed for workgroup on clinical performance measures for management of ACL injuries.
The Performance Measures Committee seeks AAOS fellows to participate in a workgroup to develop performance measures for management of anterior cruciate ligament (ACL) injuries. The Committee encourages subject matter experts to apply no later than Feb. 26, 2016. There will be a mandatory orientation webinar on Tuesday, May 24. Final decisions regarding the project scope and design will be determined at the mandatory first work group meeting in Rosemont, Ill., on Saturday, June 25. For more information, please contact Jackie Ryan, at 847-384-4337, or via email at: ryan@aaos.org
Learn more and submit your application (DOC)…