Today’s Top Story
Claims data suggest one in five privately insured may have been prescribed opioids during 2015.
A report released by the Blue Cross and Blue Shield (BCBS) Association finds that 21 percent of commercially insured BCBS members filled at least one opioid prescription in 2015, and that those with an opioid use disorder diagnosis spiked 493 percent over the 7-year study period. The researchers reviewed medical claims from BCBS commercially insured members from 2010 through 2016. Other findings of the report include:

  • Among patients 45 years and older, women have a higher rate of opioid use disorder compared to men. However, among people younger than 45 years, men have higher rates of opioid use disorder.
  • Long-duration prescription opioid use and opioid use disorder overlap by region, with the highest rates in the South and the Appalachian Region.
  • Patients who fill high-dosage opioid prescriptions have much higher rates of opioid use disorder than patients who fill low-dose prescriptions across both short- and long-duration regimens.

Read more…
Read the complete report…

Other News

Study: Radiofrequency denervation may not be effective for pain reduction for certain patients with chronic low back pain.
Findings from a study conducted in the Netherlands and published in the July 4 issue of The Journal of the American Medical Association suggest that radiofrequency denervation may not reduce pain for patients with chronic low back pain who and are treated with a standardized exercise program. The research team reviewed data on 681 participants from three pragmatic, multicenter, nonblinded, randomized clinical trials on the effectiveness of minimal interventional treatments for participants with chronic low back pain who and were treated with either a 3-month standardized exercise program or radiofrequency denervation plus the standardized exercise program. At 3-month and 12-month follow-ups, the research team found either no improvement or no clinically significant improvement in chronic low back pain for patients who received radiofrequency denervation compared to the standardized exercise program alone. The research team states that the findings do not support the use of radiofrequency denervation to treat chronic low back pain from the sources studied (facet joint, sacroiliac joint, or a combination of facet joints, sacroiliac joints, or intervertebral disks). Read the abstract…

Study: Rate of recurrent CDI on the rise.
A study published online in the journal The Annals of Internal Medicine notes an increase in rates of multiply recurrent Clostridium difficile infection (mrCDI). The authors conducted a retrospective cohort study of 38,911,718 commercially insured patients, 45,341 of whom developed C. difficile infection (CDI). They found that, from 2001 to 2012, the annual incidence of CDI and mrCDI per 1,000 person-years increased by 42.7 percent and 188.8 percent, respectively. The increase in mrCDI incidence was independent of known risk factors for CDI. Patients who developed mrCDI were older, more likely to be female, and more likely to have used antibiotics, proton-pump inhibitors, or corticosteroids within 90 days of CDI diagnosis. In addition, chronic kidney disease and diagnosis in a nursing home were also associated with increased risk for mrCDI. Read more…
Read the abstract…

CMS releases 2016 Open Payments data.
The U.S. Centers for Medicare & Medicaid Services (CMS) has released Open Payments data for 2016. An article in Medscape reports that 631,000 clinicians reported a total of $8.18 billion in payments during 2016. Overall, clinicians received $4.36 billion for research, $1.02 billion in the value of ownership or investment interests, and $2.8 billion in general payments (i.e., meals, consulting and speaking fees, travel, and lodging, etc.). Under the Open Payments system, drug and device makers are required to report “transfers of value” of $10 or more, or as well as transfers of value that add up to more than $100 per year. Read more…
Visit the Open Payments website…

CMS offers resource to help clinicians working in small, rural, or under-served areas participate in the QPP.
CMS has announced the launch of a new section on the Quality Payment Program (QPP) website dedicated to clinicians working in small or rural practices, or treating patients in underserved areas. The site offers an interactive map to help providers quickly locate contact information for the organizations providing assistance to practices through the Small, Underserved, and Rural Support initiative. Training and education resources are available nationwide and provided at no cost to eligible clinicians and practices. In addition, the site contains information on flexibilities to help reduce the participation and reporting burden on small practices for 2017. View the site…

Texas.
The Credentialing Resource Center reports that a law signed by the governor of Texas bans the Texas Medical Board from requiring maintenance of certification as a requirement for physicians to obtain or renew their Texas medical license. In addition, the law prohibits hospitals and health plans from differentiating between physicians who have undergone the process and those who haven’t in matters related to payment, contracting, or credentialing, unless the medical staff votes in favor of differentiation. If the medical staff votes to allow differentiation, it has to establish appropriate grandfathering provisions. The law is set to go into effect on Jan. 1, 2018. Read more…

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). This committee monitors trends regarding professional liability and tort reform, and develops and prioritizes AAOS activities in that area. Applicants for this position must be active fellows with an interest in legal issues that involve 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)