Today’s Top Story
OIG to review accuracy of 6 years of meaningful use payments
Healthcare IT News reports that the U.S. Department of Health and Human Services Office of Inspector General (OIG) plans to review the accuracy of $14.6 billion in Medicare meaningful use payments made to hospitals between 2011 and 2016. From Jan. 1, 2011, to Dec. 31, 2016, U.S. Centers for Medicare & Medicaid Services (CMS) electronic health records incentive payments totaled $14.6 billion, and OIG has previously estimated physicians to have been wrongfully paid $729 million under the meaningful use program. The U.S. Government Accountability Office has identified improper incentive payments as the primary risk to the Medicare EHR incentive program. Read more…
Read the OIG statement…

Other News

Study: What factors affect episode-of-care payments for younger TJA patients?
A study published online in the journal Clinical Orthopaedics and Related Research examines factors linked with 90-day episode-of-care payments for younger patients who undergo total joint arthroplasty (TJA). The research team reviewed claims data for 11,131 procedures from a single private insurer. They found that the mean total payment for a 90-day episode for TJA was $47,700 (based on 2013 dollars). Overall, 14 percent of 90-day episode payments was attributable to postdischarge-care services—substantially less than the percentage estimated in the Medicare population. The research team notes that prolonged length of stay, any 90-day unplanned readmission, computer-assisted surgery, initial home discharge with home health component, and very high patient morbidity burden were associated with increased TJA payments. Hospital-level factors associated with higher payments included urban location, lower hospital case mix based on average relative diagnosis related group weight, and large hospital size (based on total discharge volume). Read the abstract…

Study: Obese patients may benefit from THA and TKA.
Findings from a study published in the July 19 issue of The Journal of Bone & Joint Surgery suggest that obese patients may see pain relief and improved function following total hip or knee arthroplasty (THA or TKA). The authors reviewed data from a national sample of 2,040 THA patients and 2,964 TKA patients. They found that increased obesity classification was linked to lower Short Form-36 Physical Component Summary (PCS) score at baseline and 6-month follow-up, and that severely and morbidly obese patients displayed less postoperative functional gain compared to the other body mass index (BMI) groups. However, a greater obesity level was associated with more pain at baseline but increased postoperative pain relief, and average postoperative pain scores did not differ significantly according to BMI status. In addition, postoperative gain in PCS score did not differ by BMI level. A greater obesity level was associated with worse pain at baseline but greater pain relief at 6 months, so the average pain scores at 6 months were similar across the BMI levels. The authors argue that obesity should not in itself be a deterrent to undergoing total joint arthroplasty to relieve symptoms. Read more…
Read the abstract…

Study: Single BMD and fracture history assessment may help predict long-term fracture risk.
According to data from a study published online in the Journal of Bone and Mineral Research, a single bone mineral density (BMD) and fracture history assessment may help predict fracture risk over 20 to 25 years. The research team reviewed data on 7,959 women aged 67 years or older from the Study of Osteoporotic Fractures, which followed patients with hip fracture for 25 years and patients with any nonvertebral fracture for 20 years. They found that the 25-year cumulative incidence of hip fracture was 17.9 percent, and the 20-year incidence of any nonvertebral fracture was 46.2 percent. The research team notes that a single femoral neck BMD measurement strongly predicted long-term hip fracture risk to 25 years, while history of hip fracture predicted hip fractures only slightly better than history of nonvertebral fracture. Read the abstract…

Study: UHMWPE surface might safely elute antibiotics while retaining mechanical strength.
A pilot study published online in the journal Nature Biomedical Engineering suggests that joint implant surfaces of ultra-high molecular weight polyethylene (UHMWPE) could be made to safely elute antibiotics to reduce risk of infection. The researchers demonstrated that modifying eccentricity of drug clusters and the percolation threshold in UHMWPE could maximize drug elution while retaining mechanical strength. “The optimized UHMWPE eluted antibiotic at a higher concentration for longer than the clinical gold standard antibiotic-eluting bone cement,” the researchers write, “while retaining the mechanical and wear properties of clinically used UHMWPE joint prostheses. Treatment of lapine knees infected with Staphylococcus aureus with the antibiotic-eluting UHMWPE led to complete bacterial eradication and the absence of detectable systemic effects.” Read more…
Read the abstract…

Act now to give your nominee for AAOS leadership an advantage!
Nominees for AAOS Board positions are asked to submit four documents. By acting today, your nominee will have more time to prepare. The following positions are open:

  • Second Vice President
  • Treasurer-Elect
  • Member-at-Large [Age 45 or Older] (on March 8, 2018)
  • Member-at-Large [Under Age 45] (younger than age 45 on March 8, 2018)
  • Nominees to the American Board of Orthopaedic Surgery (ABOS)

The nominations period closes Friday, July 28, but it’s best not to wait. Members may submit nominations electronically and access partial descriptions of the responsibilities, desired experience, and time commitments associated with each position at: Read more…(member login required)

Members may also submit nominations to Frederick M. Azar, MD, chair, 2018 Nominating Committee, c/o AAOS Office of General Counsel, 9400 West Higgins Road, Rosemont, Ill. 60018.

Call for volunteers: Panel on development of MIPS inpatient outcome measures.
AAOS seeks to nominate members to the CMS Technical Expert Panel on Development of Inpatient Outcome Measures for the Merit-based Incentive Payment System (MIPS). The panel will provide input on approaches to measure attribution that could apply to multiple measures and help shape the approach to one or two specific measures on a full range of measure specifications, including attribution, cohort, and risk adjustment. Applicants for this position must be active fellows, 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, a 100-word biosketch, a letter of interest highlighting his or her expertise in the subject area, and a CMS nomination form (available at the link below). All supporting materials must be submitted to Kyle Trivedi by July 25, 2017, at 11:59 p.m. CT, at: trivedi@aaos.org.
Learn more and download the nomination form…

Call for volunteers: Medical Liability Committee.
Aug. 1 is the last day to submit your application for a position on the Medical Liability Committee (four member openings). Members of this committee monitor trends regarding professional liability and tort reform, and serve as support and policy-making resource for AAOS Office of Government Relations and the Council on Advocacy. Applicants for this position must be active fellows with an understanding of legal issues involved in orthopaedic practice, such as tort reform advocacy, expert witness testimony, medical liability insurance, and risk management. Learn more and submit your application…(member login required)