Today’s Top Story
News organization posts database of complications for elective procedures.
ProPublica has posted an online database of complication rates for elective procedures performed by nearly 17,000 surgeons in the United States. The organization drew data from 5 years of Medicare records for eight common elective procedures, including spinal fusion and knee and hip arthroplasty. In an accompanying article, the writers note that 11 percent of surgeons in the database accounted for about 25 percent of all complications, while 756 surgeons who performed at least 50 operations did not record a single complication, and another 1,423 surgeons recorded only one complication. Read more…
View the ProPublica database…
“We welcome transparency,” said AAOS President David D. Teuscher, MD, “and certainly a database on the surgical complication rates of a patient population, undergoing specific procedures, provides important information and a potentially useful tool for patients and physicians. However, the totality of the surgical complication issue is much more complex, and cannot be effectively addressed without considering all of the variables that impact surgery, care, and outcomes.” Read more…
Other News
CMS announces results of fraud reduction initiative as lawmakers criticize other efforts.
The U.S. Centers for Medicare & Medicaid Services (CMS) reports that its Fraud Prevention System has identified or prevented $820 million in inappropriate payments over the program’s first 3 years, including $454 million in 2014 alone. The system uses predictive analytics to identify troublesome billing patterns and outlier claims for action, similar to systems used by credit card companies. The agency plans to continue to expand the Fraud Prevention System and its algorithms to identify lower levels of non-compliant healthcare providers who may be better served by education or data transparency interventions. Read more…
On a related note, members of the U.S. House of Representatives Energy and Commerce oversight subcommittee criticized the Obama administration for not fully implementing nine recommendations from the U.S. Department of Health and Human Services Office of Inspector General (OIG) to reduce fraud in the Medicare Part D drug program, even though some of those recommendations date to 2006. Read more…
Read the OIG report (PDF)…
Study: Implementation of audit initiative may improve care and survival for hip fracture patients.
According to findings published in the August issue of the journal Medical Care, a national, clinician-led, audit initiative was linked to substantial improvements in care and survival of older people with hip fracture in England. The researchers reviewed data on 471,590 patients aged 60 years or older who were admitted with a hip fracture to National Health Service hospitals in the United Kingdom. They found that, after the 2007 launch of the U.K. National Hip Fracture Database, rates of early surgery increased from 54.5 percent to 71.3 percent, and 30-day mortality fell from 10.9 percent to 8.5 percent. In addition, the annual relative reduction in adjusted 30-day mortality was 1.8 percent per year during the period from 2003 to 2007, compared with 7.6 percent per year from 2007 to 2011. Read more…
Read the abstract…
CMS proposal may be a “sea change” in reimbursement for joint arthroplasty.
An article in HealthLeaders Media looks at possible effects of a recent proposal by CMS to bundle payment and quality measures for hip and knee arthroplasty at hospitals in 75 randomly selected geographic areas. One stakeholder points out that the move is based on information from a CMS demonstration project, which found that more than half the cost of providing care for joint arthroplasty occurred post-surgery. “On the hospital side we can expect to see demand destruction in areas such as diagnostic testing, hospital stays, and avoidable readmissions, which is a good thing,” states another observer. “Post-acute providers will see a significant hit to inpatient rehab and [skilled nursing facility] utilization as providers search for lower cost alternatives such as home health services.” Another expert calls the move a “sea change” for providers, who may see increased financial risk and increased responsibility for guaranteeing outcomes, and notes that among other things, bundling will likely “motivate providers and facilities performing the services to streamline and improve communication.” Read more…
As noted in the July 10 issue of AAOS Headline News Now, the AAOS is reviewing the proposed rule and intends to submit comments to CMS. Read more…
Study: Exercise program may help increase BMD among men with osteopenia.
Data from a study to be published in the October issue of the journal Bone suggest that implementation of an exercise program may be associated with an increase in bone mineral density (BMD) and bone turnover markers (BTM) in physically active men with osteopenia of the hip or spine. The authors examined the effects of resistance training or jump training among 38 physically active, middle-aged men who completed either a weight-lifting program (n = 19) or a jumping program (n = 19) for 1 year. Both programs required participants to complete 60 to 120 minutes of targeted exercises each week, and participants took calcium and vitamin D supplements for the duration of the program. At 6 months after program start, the authors found that whole body and lumbar spine BMD had significantly increased among participants in both cohorts—increases that were maintained at 12 months. They noted that total hip BMD increased only among those in the weightlifting program. Read more…
Read the abstract…
Dependence on prescription opioids a strong risk factor for heroin use.
A report from the U.S. Centers for Disease Control and Prevention (CDC) finds that heroin use is on the rise in the United States, and that the strongest risk factor for heroin abuse or dependence is dependence on prescription opioids. A guide published by the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) offers clinical guidance for providers whose patients may have an opioid use disorder. Read more…
Read the CDC report…
Read the SAMHSA guide (PDF)…
Study: Athlete-to-athlete contact may be most frequent mechanism of concussion in youth soccer.
According to a study published online in the journal JAMA Pediatrics, athlete-to-athlete contact, not heading the ball, may be the most frequent mechanism of concussion in soccer. The researchers conducted a retrospective analysis of longitudinal surveillance data collected from 2005 through 2014 across a nationally representative sample of U.S. high schools. Among girls, the researchers noted 627 concussions during 1,393,753 athlete exposures, with 51.3 percent of concussions linked to athlete-to-athlete contact, and 25.3 percent linked to heading. Among boys, the researchers found 442 concussions across 1,592,238 athlete exposures, with 68.8 percent linked to athlete-to-athlete contact, and 30.6 percent linked to heading. Read the abstract…
Call for volunteers: Publications Committee.
August 14 is the last day to submit your application for a position on the Publications Committee (three member openings). The Publications Committee develops and oversees both print and electronic/online publications to meet the educational needs of orthopaedic surgeons. Applicants for this committee must be active fellows, candidate members, or candidate member applicants for fellowship. the committee seeks orthopaedic surgeons from all specialties, but one of the selected candidates must have a focus in shoulder and elbow and one must have a focus in sports medicine. Learn more and submit your application…(member login required)
