Today’s Top Story
CMS publishes 2017 Hospital Outpatient Prospective Payment Proposed Rule.
The U.S. Centers for Medicare & Medicaid Services (CMS) has released a proposed rule for the 2017 Hospital Outpatient Prospective Payment System and the Medicare Ambulatory Surgical Center Payment System. Among other things, CMS proposes the following actions:

  • Implement Section 603 of the Bipartisan Budget Act of 2015, which will affect how Medicare pays for certain items and services furnished by certain off-campus outpatient departments of a provider
  • Remove the Pain Management dimension of the HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey from Medicare’s Hospital Value Based Purchasing Program
  • Make several changes to the objectives and measures of the Medicare Electronic Health Record (EHR) Incentive Program for eligible hospitals and critical access hospitals attesting under the Medicare EHR Incentive Program

Comments on the proposed rule must be submitted by Sept. 6, 2016.
Read more…
Read the rule…
Read the CMS press release…

Other News

CMS continues to allow a 90-day reporting period for Electronic Health Records (EHR) in 2016.
CMS is proposing a 90-day EHR reporting period in 2016 for all eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs), to assist healthcare providers and increase flexibility in the program. The EHR reporting period would be any continuous 90-day period between Jan. 1, 2016, and Dec. 31, 2016. The American Hospital Association and the College of Healthcare Information Management Executives both praised CMS for shortening the meaningful use reporting period. CMS is also looking to eliminate the Clinician Decision Support and Computerized Provider Order Entry objectives and measures for eligible hospitals and CAHs, Healthcare IT News reports, and proposed lowering thresholds for some meaningful use stage 2 measures. EPs, eligible hospitals, and CAHs that have not successfully demonstrated meaningful use in a prior year would be required to attest to Modified Stage 2 (instead of Stage 3) by Oct. 1, 2017.
Hardship exemption: CMS is proposing that certain EPs, who have not successfully demonstrated meaningful use in a prior year but intend to attest to meaningful use for an EHR reporting period in 2017, and intend to transition to MIPS and report on measures specified for the advancing care information performance category under the MIPS as proposed in 2017, can apply for a significant hardship exception from the 2018 payment adjustment.
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Report calls for reforms in VA health system to provide expanded access to private care.
A bipartisan commission’s report to the White House calls for an overhaul of the Department of Veterans Affairs (VA) health system that would expand veterans’ care options with the establishment of community networks staffed in part by independent providers credentialed by the VA. The system would replace a current program that allows some veterans to obtain care from practitioners outside the VA system but that has been widely criticized as cumbersome and inadequate. The commission said the VA is afflicted by “profound deficiencies” and should undergo a “bold transformation,” the Arizona Republic reports. Two of the 15 members of the commission dissented from the report and wrote that the recommendations fell “far short” of needed reforms.
Read more…
Read in the Wall Street Journal(paid subscription required)
Read the report (PDF)…

Study: What factors are linked to chronic exertional compartment syndrome in pediatric patients?
A study published online in The American Journal of Sports Medicine examines outcomes and demographics of chronic exertional compartment syndrome (CECS) among pediatric patients. The research team conducted a retrospective review of 155 patients (136 female) 18 years or younger who were treated surgically for CECS with compartment release at a single institution. The research team states that all patients had leg pain and that 8 patients (5 percent) also had neurologic symptoms; 131 patients (85 percent) had bilateral symptoms requiring bilateral compartment release. The most common primary sports were running (25 percent), soccer (23 percent), and field hockey (12 percent), with 50 percent of patients being multisport athletes. Of 286 legs, 138 (48 percent) had only anterior and/or lateral compartments released, while 84 (29.4 percent) had all 4 compartments released. Overall, 79.5 percent of patients returned to sport. Of 250 legs for which outcomes analysis was performed, 47 (18.8 percent) had recurrent CECS requiring reoperation at a median of 1.3 years after initial compartment release. Legs with only anterior and/or lateral compartment released had 3.4 times the likelihood of reoperation compared with legs that had all 4 compartments released.
Read the abstract…

Study: Inexpensive surgical skills curriculum may improve training for young orthopaedic residents.
Findings from a small study published in the July/August issue of the Journal of Surgical Education suggest that an inexpensive, month-long, surgical skills curriculum may help improve training for orthopaedic interns. The researchers conducted a retrospective study of 5 PGY-1 orthopaedic surgery residents and 16 faculty who participated in a curriculum that included anatomic study, surgical approaches, joint-specific physical examination, radiographic interpretation, preoperative planning, reduction techniques, basic emergency and operating room procedures, cadaveric procedure practice, and introduction to arthroplasty. The program ran for a cumulative 89 hours, including 14.5 hours working with cadaveric specimens, and cost $8,100 to implement. The average module received a 4.15 rating on a 5-point scale, with 4 representing “good” and 5 representing “excellent.”
The researchers note that the program also fostered early relationships between interns and faculty, which was an unexpected benefit.
Read the abstract…

Last call to submit abstracts for the Orthopaedic Video Theater at the 2017 AAOS Annual Meeting!
Share your knowledge with orthopaedic surgeons from around the world at the 2017 AAOS Annual Meeting, to be held March 14–18, 2017, in San Diego. Nowhere else will your discoveries reach such a wide-ranging orthopaedic audience! July 15 is the deadline to submit abstracts for the Orthopaedic Video Theater. Please note that, prior to abstract submission, presenters and all coauthors must disclose current financial relationships in the AAOS Disclosure Database Program. Disclosure reported on April 1, 2016, or later is acceptable.
Submit your abstract…
Update your disclosures…

Call for volunteers: Program Committees.
Aug. 17 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 at the AAOS Annual Meeting. The following openings are available:

  • Adult Reconstruction Hip (eight members)
  • Adult Reconstruction Knee (two members)
  • Practice Management/Rehabilitation (five members)
  • Shoulder & Elbow (one member)
  • Sports Medicine/Arthroscopy (two members)
  • Trauma (five 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)