Today’s Top Story
CMS proposal would bundle payment and quality measures for hip and knee arthroplasty procedures at many hospitals.
The U.S. Centers for Medicare & Medicaid Services (CMS) has issued a proposed rule to bundle payment and quality measures for hip and knee arthroplasty at hospitals in 75 randomly selected geographic areas. Most hospitals in those regions would be required to participate. Under the proposal, the hospital in which the procedure is performed would be accountable for costs associated with the entire episode of care, from the time of surgery through 90 days postoperative. If adopted, the proposal is expected to affect more than 100,000 Medicare beneficiaries starting in January.
AAOS is reviewing the proposed rule and intends to submit comments to CMS. Read more…
Read the CMS fact sheet…
Read the proposed rule (PDF)…
Read the AAOS response…

Other News

CMS proposes 0.5 percent overall increase in physician reimbursement for 2016.
Physicians would see a 0.5 percent overall increase in Medicare reimbursement in 2016, under a proposed revision to the Medicare physician fee schedule released by CMS. The fee schedule, which is the first to be issued since Congress repealed the Medicare sustainable growth rate payment formula, includes some adjustments to relative value units (RVUs) used to calculate the volume of work or effort expended by a physician in treating patients. If adopted, the proposal would also allow for reimbursement for physician who discuss patients’ wishes regarding end-of-life care. Read more…
Read the proposed rule (PDF)…

FDA strengthens existing warning linking NSAID use to risk of heart attack or stroke.
The U.S. Food and Drug Administration (FDA) is strengthening an existing label warning that NSAIDs increase the chance of a heart attack or stroke. Based on a comprehensive review of new safety information, the agency is requiring updates to the drug labels of all prescription NSAIDs. Among other things, prescription NSAID labels will be revised to reflect the following information:

  • The risk of heart attack or stroke can occur as early as the first weeks of using an NSAID. The risk may increase with longer use of the NSAID. This risk appears greater at higher doses.
  • NSAIDs can increase the risk of heart attack or stroke in patients with or without heart disease or risk factors for heart disease.
  • In general, patients with heart disease or risk factors for it have a greater likelihood of heart attack or stroke following NSAID use than patients without these risk factors because they have a higher risk at baseline.
  • There is an increased risk of heart failure with NSAID use.

Read more…

Study: Athletes who undergo ACL repair may not need simultaneous surgical treatment of smaller and more stable meniscal tears.
According to data presented at the annual meeting of the American Orthopaedic Society for Sports Medicine (AOSSM), it may not be necessary to surgically treat meniscus tears at the time of anterior cruciate ligament (ACL) surgery. The researchers examined 194 athletes with meniscus tears who did not receive surgical treatment at the time of ACL repair, and noted that 97.8 percent of patients with untreated lateral meniscus tears and 94.4 percent of patients with untreated medial tears had required no reoperation for at least 6 years after the index surgery. Overall, 16 tears (7.7 percent) required reoperation, with increased likelihood for reoperation among younger patients and those with a tear greater than 10mm. Read more…

Study: Arthroscopic treatment for MDI of the shoulder may be effective when conservative treatment fails.
Findings presented at the annual meeting of AOSSM suggest that surgical treatment may be effective for athletes who experience multidirectional instability (MDI) of the shoulder. The research team examined 41 athletes (22 men, 19 women) who had received conservative treatment for MDI that was unsuccessful in addressing the condition and who subsequently underwent arthroscopic surgery. They found that 73 percent returned to play at equal or only slightly lower levels than before. Read more…

President Obama names CMS acting administrator to run agency on more permanent basis.
President Obama has nominated Andrew M. Slavitt to be the next administrator of CMS. Mr. Slavitt has served as acting administrator of the agency since Marilyn Tavenner stepped down in February. Some congressional leaders have signaled concerns about the nomination, due to Mr. Slavitt’s previous connections to at least one large medical insurance company. Read more…

Your help is needed! Voting reopened on AAOS resolutions and bylaws.
Balloting on AAOS resolutions and bylaw amendments has reopened. A vote of at least 20 percent of fellows is required for an official vote. If you have not voted, please help by casting your ballot to retain or rescind AAOS resolutions or bylaw amendments. The ballot should take no more than 2 minutes of your time. Cast your ballot…(member login required)

Call for volunteers: Various liaison positions.
AAOS seeks to nominate members to several external liaison positions. The following positions are available, with a deadline of July 14:

  • Liaison to the U.S. Agency for Healthcare Research & Quality Evidence Based-Practice Center Technical Expert Panel on osteoarthritis of the knee
  • Global Alliance for Musculoskeletal Health: Musculoskeletal Models of Care panel
  • U.S. Government Accountability Office Physician-Focused Payment Model Technical Advisory Committee

Applicants for these positions must be active fellows, candidate members, candidate members osteopathic, candidate member applicants for fellowship, or candidate member applicant for fellowship osteopathic. 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 highlighting his or her expertise in the subject area and a statement that he or she is able to participate in full capacity. All supporting materials must be submitted to Kyle Shah by Tuesday, July 14, 2015 at 11:59 p.m. CT, at shah@aaos.org.
Learn more and submit your application…(member login required)