Today’s Top Story
CMS projects healthcare spending to grow 5.8 percent per year.
The U.S. Centers for Medicare & Medicaid Services (CMS) has released a report that projects total healthcare spending to increase an average of 5.8 percent per year during the period 2014 through 2024. The authors note that the rate is less than the 9 percent average seen in the three decades leading up to 2008. Other findings of the report include the following:

  • Approximately 19.1 million additional people are expected to enroll in Medicare during the next 11 years as more members of the so-called “baby boom generation” become eligible.
  • The overall insured rate is expected to rise from 86.0 percent to 92.4 percent over the next 11 years.
  • Medicaid spending during 2014 is projected to have decreased by 0.8 percent because new enrollees are expected to be somewhat healthier than those who were enrolled previously. Overall spending, however, is projected to have increased by 12.0 percent in 2014, as a result of a 12.9 percent increase in enrollment related to coverage expansion under the Affordable Care Act.

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Other News

CMS releases guidance document on ICD-10 transition.
Health Data Management reports that CMS has released a guidance document for physicians to help manage the transition to ICD-10. As previously announced, the agency plans to establish an ombudsman office to help resolve problems during the transition, and will not penalize physicians for errors in selecting and calculating quality codes for the meaningful use, Physician Quality Reporting System, and Value-based Modifier reporting programs as long as they use codes within the appropriate family of codes. Read more…
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Study: HACs may be strongest predictor of readmission after primary hip or knee arthroplasty.
Hospital-acquired conditions (HACs) were the strongest predictor of readmission after primary hip or knee arthroplasty, according to a study published in the August issue of The Journal of Arthroplasty. The authors attempted to identify risk factors for readmission after hip and knee arthroplasty, using national Veteran’s Administration data on 26,710 total and partial primary arthroplasty procedures (16,808 knees and 9,902 hips) across 96 hospitals between 2005 and 2009. The retrospective cohort study found the overall 30-day readmission rate to be 7.3 percent (n = 1940), with readmission rates of 8.4 percent for hip arthroplasty and 6.6 percent for knee arthroplasty. HACs accounted for 42 percent of all complications. Among HACs, urinary tract infections were the most common, followed by surgical site infections, venous thromboembolism, and pneumonia. Read the abstract…

Study: Different methods of placebo intervention linked to different clinical responses in OA treatment trials.
A meta-analysis of placebo-controlled osteoarthritis (OA) treatment trials published online in the journal Annals of Internal Medicine suggests that method of placebo intervention may produce different clinical responses, thereby affecting interpretation of results. The researchers analyzed 149 randomized trials of adults with knee OA that compared widely used pharmaceuticals against oral, intra-articular, topical, and oral plus topical placebos. They found that intra-articular placebo and topical placebo were associated with significantly greater effect sizes than oral placebo. A differential model displayed marked differences in the relative efficacies and hierarchy of the active treatments compared with a network model that considered all placebos equivalent. In the model accounting for differential effects, intra-articular and topical therapies were superior to oral treatments in reducing pain, but when differential effects were ignored, oral nonsteroidal anti-inflammatory drugs were superior. The researchers note that because few of the studies directly compared different placebos, their analysis could not decisively conclude whether disease severity and co-interventions systematically differed between trials evaluating different placebos. Read the abstract…

Lexology reports that the Supreme Court of Georgia has rejected a defendant’s argument that the plaintiff’s proposed expert in a medical liability case was unqualified to testify, as the expert had performed no more than one of the exact type of procedure at issue within the last 5 years. The court determined that a rule regarding expert witnesses does “not require that an expert actually have performed or taught the very procedure at issue,” but only that the expert have an appropriate level of knowledge. Read more…

A survey of members of the Tennessee Medical Association finds that many physicians in the state find the cost and effort associated with specialty certification and recertification to be unreasonable, with little return on investment in terms of patient care. Among the survey findings are the following:

  • One in four physicians said they intend to relinquish their board specialty certifications before retiring from medicine, and 74 percent plan to let them lapse after they retire.
  • Approximately 64 percent of respondents have had multiple recertifications after their residency or fellowship, and more than half of those have undergone recertification two or more times.
  • More than one in three physicians begin preparing for recertification at least 1 year in advance.
  • The average cost among respondents to become certified by their specialty boards is approximately $2,250.

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View the survey data (PDF)…

Act now to nominate future AAOS leadership!
The 2016 Nominating Committee is actively soliciting your suggestions for individuals to serve in the following positions:

  • Second Vice President
  • Treasurer
  • Member-at-Large [Age 45 or Older] (age 45 or older on March 3, 2016)
  • Member-at-Large [Under Age 45] (younger than age 45 on March 3, 2016)
  • National Membership Committee Member
  • Nominees to the American Board of Orthopaedic Surgery (ABOS)

Nominations will close on Friday, Aug. 14. Please submit nominations to John R. Tongue, MD, chair, 2016 Nominating Committee, c/o AAOS Office of General Counsel, 9400 West Higgins Road, Rosemont, IL 60018, or online at:

Call for volunteers: Program Committees.
Sept. 1 is the last day to submit your application for a position on a Program Committee. Members of Program Committees grade symposia in May and abstracts in June and July, and may serve as moderators for paper sessions and critical evaluators of courses at the AAOS Annual Meeting. The following positions are available:

  • Foot & Ankle (three members)
  • Hand & Wrist (one member)
  • Musculoskeletal Tumor & Metabolic Disease (one member)
  • Practice Management/Rehabilitation (four members)
  • Spine (one member)
  • Sports Medicine/Arthroscopy (five members)
  • Trauma (eight members)

Applicants for these positions must be active fellows or international affiliate members with a practice emphasis in the relevant area. Learn more and submit your application…(member login required)