Today’s Top Story
Senate panel seeks delay of Stage 3 MU rules.
The U.S. Senate Health, Education, Labor and Pensions Committee is asking the U.S. Department of Health and Human Services (HHS) to delay Stage 3 meaningful-use (MU) rules—expected to go into effect in 2017—as part of a push to expand the adoption of electronic health records, Modern Healthcare reports. The concern is that medical providers will need to rely heavily on the actions of others to fulfill Stage 3 requirements. The rules require providers to send electronic summaries for 50 percent of patients they refer to other providers, receive summaries for 40 percent of patients who are referred to them, and reconcile past patient data with current reports for 80 percent of such patients. Read more…(registration may be required)

Other News

Anthem to buy Cigna.
Health insurer Anthem Inc. announced today plans to acquire rival Cigna Corp. for $48.3 billion, the New York Times reports, although other sources put the deal closer to $54 billion. The combined company would serve more than 53 million people, making it the largest U.S. health insurer by enrollment. According to the New York Times article, the proposed deal is another move by health insurers to consolidate to gain greater scale to reduce costs and capitalize on growing opportunities in the government and individual markets. Aetna agreed to acquire Humana earlier this month. Read more…

Study: Patients with better preoperative function may be less likely to obtain meaningful improvement after THA.
Research published in the journal Clinical Orthopaedics and Related Research finds that preoperative patient-reported outcome measures (PROMs) may predict whether patients who undergo total hip arthroplasty (THA) will have clinically meaningful improvements in functional outcomes 1 year after surgery. The retrospective cohort study evaluated SF12 version 2 (SF12v2) and Hip Disability and Osteoarthritis Outcome Score (HOOS) scores of 537 primary unilateral THA patients. A distribution-based method was used to determine the minimum clinically important differences (MCIDs) for HOOS and SF12v2 physical component summary (PCS) scores, calculated to be 9.1 and 4.6, respectively. The researchers also studied the effect of SF12v2 mental component summary (MCS) scores on threshold values for SF12v2 PCS and HOOS scores. According to the study results, as preoperative mental and emotional health improved—as indicated by a higher MCS score—HOOS and PCS threshold values also increased. Patients whose HOOS or PCS scores indicated they had a higher level of preoperative function were less likely to obtain meaningful improvement after THA. The researchers stated that “the results of this study may be used to facilitate discussion between physicians and patients regarding the expected benefit after THA and to support the development of patient-based informed decision-making tools.” Read more…

Study: Orthopaedists express concerns about patient safety.
According to a study recently published in The Journal of Bone & Joint Surgery (JBJS), many orthopaedic surgeons have concerns regarding the perceived safety climate, and are interested in employing strategies for enhancing patient safety. In the study, members of the Science of Variation Group (an international collaboration of 691 upper extremity surgeons) and Ankle Platform (an international collaboration of 350 lower extremity surgeons) completed an 89-question survey regarding patient safety. The researchers measured outcomes with the modified Patient Safety Climate in Healthcare Organizations questionnaire, which evaluates safety as perceived by hospital personnel, and the amount of interest expressed for using 17 means of improving safety. Of the 387 participants who completed the questionnaire, the rate of problematic responses—those that indicated a lack of safety climate—was 18 percent. Perceived safety was higher among men, surgeons working in a nonteaching hospital, and surgeons working in a hospital with a safety program. The majority of respondents were enthusiastic about the concept that safety is everyone’s responsibility (75 percent), promoting more effective communication (80 percent), standardizing procedures (80 percent), and standardizing equipment and supplies (63 percent) with the goal of improving patient safety. Read more…

Top US News & World Report ranking for orthopaedics goes to Hospital for Special Surgery.
U.S News & World Report has released its rankings for the best hospitals for orthopaedics, and for adult care, it gives the top rating to the Hospital for Special Surgery, followed by the Mayo Clinic and the Cleveland Clinic. Hospitals were considered if they treated at least 337 inpatients in 2011, 2012, and 2013. Rounding out the top 10 were:

    1. Massachusetts General Hospital
    2. Hospital for Joint Diseases, NYU Langone Medical Center
    3. Rush University Medical Center
    4. Brigham and Women’s Hospital
    5. Santa Monica-UCLA Medical Center
    6. Northwestern Memorial Hospital
    7. New England Baptist Hospital

For pediatric orthopaedics, the top three were Children’s Hospital of Philadelphia, Rady Children’s Hospital, and Boston Children’s Hospital. The top three hospitals overall were Massachusetts General Hospital, Mayo Clinic, and, in a tie, Johns Hopkins Hospital and UCLA Medical Center. Read more…
See the rankings for pediatric orthopaedics…
See the rankings for hospitals overall…

Study: Outcomes the same for orthopaedic surgeons and neurosurgeons.
A study published in Spine compared outcomes achieved by orthopaedic surgeons and neurosurgeons operating on the spine and found that the two specialty groups achieved equivalent outcomes in the metrics of mortality, 30-day readmission, and surgical site infection. The study involved 9,719 patients undergoing a spinal fusion between 2005 and 2011 as identified in the American College of Surgeons’ National Surgical Quality Improvement Program database; 54 percent had their operation performed by a neurosurgeon. In their practices, the orthopaedic surgeons had a greater percentage of lumbar spine cases (76 percent vs. 65 percent; P < 0.001). There was no significant difference between specialties in the number of levels fused or operative technique used. Procedures done by neurosurgeons did demonstrate a lower incidence of blood transfusion (8.3 percent vs. 14.6 percent; P <0.001); however, the authors write, “The cause of this difference is unclear and warrants further investigation to assess the impact, if any, on patient outcomes and costs.”> Read more…

Physicians in the state have until July 31 to review the individual quality scores they received in May under the new quality rating program through the California Healthcare Performance Initiative System (CHPI), and to report any discrepancies. The program rates physicians using claims data from Medicare fee-for-service, Anthem Blue Cross, Blue Shield of California, and United Healthcare and assigns physicians a star rating of one to four stars for each measure, based on where they fall as a percentile within a “peer group,” plus a composite score. Physicians who wish to verify the accuracy of the data used to calculate their scores can do so through the CHPI online portal. In order to access the review and correction portal, physicians will need their medical license number and the physician identifier (Physician ID) from the upper left corner of their mailed report. After the close of the review period, discrepancies will be reviewed, scores will be recalculated, and the ratings will be released to the public. Read more…
Access the CHPI online portal…
Verify inclusion in the CHPI ratings…

Call for volunteers: Evaluation Committees.
Aug. 15 is the last day to submit your application for an opening on an Evaluation Committee. Members of Evaluation Committees write questions for orthopaedic self-assessment examinations. The following positions are available:

  • Adult Spine (chair, five member openings)
  • Foot & Ankle (chair, seven members)
  • Hip, Knee & Adult Reconstruction (five members)
  • Orthopaedic Basic Science (11 members)
  • Trauma (seven members)

Applicants for chair openings must be active fellows. Applicants for member openings must be active fellows, candidate member applicants for fellowship, or emeritus fellows with a practice emphasis in the relevant topic. Learn more and submit your application…(member login required)