Today’s Top Story
CMS releases proposed Medicare Physician Fee Schedule for 2018.
The U.S. Centers for Medicare & Medicaid Services (CMS) has released its proposed 2018 Medicare Physician Fee Schedule. Among other things, the proposal includes:

  • An overall update to payments of +0.31 percent.
  • Implementation of the Medicare Appropriate Use Criteria Program for Advanced Diagnostic Imaging in a manner designed to allow practitioners more time to focus on and adjust to the Quality Payment Program.
  • A change from current Physician Quality Reporting System (PQRS) program policy that requires reporting of nine measures across three National Quality Strategy domains to only require reporting of six measures for the PQRS
  • A reduction in 2018 penalties for not meeting minimum quality reporting requirements under the Merit-based Incentive Payment System.

Read more…
Read the proposed rule…

Other News

Nearly 10 percent of Medicare Advantage payments may be improper.
In a hearing before the U.S. House of Representatives Committee on Ways and Means Oversight Subcommittee, a representative of the U.S. Government Accountability Office (GAO) noted that CMS has estimated that nearly 10 percent ($16.2 billion) of Medicare Advantage payments made during FY2016 were either fraudulent or linked to billing mistakes. Among other things, GAO recommends that CMS seek legislation to allow recovery audit contractors, who are currently paid on a postpayment contingency basis from recovered payments, to conduct prepayment reviews, although CMS has so far disagreed with that recommendation. Read more…
Read the hearing testimony…

Study: How does minimally invasive compare to more open approach for lumbar fusion?
A study published in the July issue of The Spine Journal examines the use of minimally invasive lumbar spine fusion compared to open approach. The research team conducted an observational analysis of prospective data on 1,947 patients who underwent elective interbody lumbar fusion using either minimally invasive technique (n = 467) or a traditional open approach (n = 1,480). They found that patients in the minimally invasive cohort had reduced blood loss and a shorter length of stay for one-level fusion but an equivalent length of stay for two-level fusion compared to patients in the open cohort. However, in both unadjusted and propensity-matched comparison, patients in both groups experienced similar return to work, patient-reported pain, physical disability, and quality of life at 3- and 12-months follow-up. Read the abstract…

Study: Arthroscopic superior capsule reconstruction may be treatment option for irreparable rotator cuff tears.
Data from a study conducted in Japan and presented at the American Orthopaedic Society for Sports Medicine (AOSSM) annual meeting suggest that arthroscopic superior capsule reconstruction may be a viable surgical option for irreparable rotator cuff tears. The researchers performed arthroscopic superior capsule reconstruction on 102 shoulders (100 patients) with irreparable rotator cuff tears and that had failed conservative treatment. At mean 48-month follow-up, they found that all 26 patients who had played (mostly recreational) sports prior to injury had returned fully to their previous participation levels. In addition, 32 patients had returned fully to their previous jobs, while two patients returned with reduced hours and workloads Furthermore, 95 of 102 shoulders (93.1 percent) had no graft tear or no re-tear of the repaired rotator cuff tendon during the follow-up period, while three shoulders (2.9 percent) with severe fatty degeneration of the infraspinatus tendon had re-tear of the repaired infraspinatus tendon at 3 months following surgery. Four shoulders (3.9 percent) suffered a postoperative graft tear by 3 months (2 patients) or 1 year (2 patients) after surgery. Following arthroscopic superior capsule reconstruction, average clinical outcome scores and shoulder active range of motion improved significantly at final follow-up. Read more…
Read the abstract (PDF; paper 165)…

Study: Increased sport specialization linked to increased risk of lower extremity injury for adolescent players.
According to findings presented at the AOSSM annual meeting, increased sport specialization may be associated with increased likelihood of lower extremity injury among younger patients. The authors recruited a diverse sample of 1,544 interscholastic high school athletes during the 2015/2016 school year, covering 2,843 athletic seasons and 167,349 athletic exposures. Overall, 60 percent of participants were classified as low specialization (based on a previously published three-item specialization scale), 27 percent moderate specialization, and 13 percent high specialization. The authors noted that 235 participants (15 percent) sustained a total of 276 lower extremity injuries that caused them to miss a median of 7 days. Compared to participants with low specialization, the hazard ratio for moderately specialized participants was 1.51, and the hazard ratio for highly specialized participants was 1.85. Read more…
Read the abstract (PDF; paper 182)…

Volunteers needed to develop CPG on treatment of glenohumeral joint OA.
AAOS seeks fellows to participate on the clinical practice guideline (CPG) on the Treatment of Glenohumeral Joint Osteoarthritis (OA) workgroup. Workgroup members will be required to complete the AAOS conflict of interest enhanced disclosure form online and attend two mandatory meetings in Rosemont, Ill. If you are interested, please contact Mary DeMars by Monday, July 31, 2017, at: demars@aaos.org.

Call for volunteers: Biomedical Engineering Committee.
Aug 1 is the last day to submit your application for a position on the Biomedical Engineering Committee (four member openings). This committee monitors and reviews scientific regulatory developments in the field of biomedical engineering as they relate to orthopaedic surgery. Applicants for this position must be active fellows with a practice emphasis on either adult reconstruction or spine. Learn more and submit your application…(member login required)