July 9, 2018 | Today’s News

Medical device security guidance sought

Following a request for information (RFI) from the House Energy and Commerce Committee, comments by many industry members support an appeal for Congress to provide financial support, guidance, and Food and Drug Administration (FDA) standards for medical device security. The American Hospital Association said bolstering cybersecurity can be difficult due to legacy systems that are not easy or cost effective to fix. The American Alliance of Orthopaedic Executives estimated that the cost of cybersecurity upkeep was about $60,789 per practice and suggested that the federal government provide assistance through incentivizing adherence to security policy updates. The ECRI Institute suggested that healthcare organizations monitor and report cybersecurity threats and security events to the FDA and research groups.

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Read the RFI…

CMS extends Bundled Payment for Care Improvement Advanced model timeline

The Centers for Medicare & Medicaid Services (CMS) will allow more time for providers to decide whether to opt into the Bundled Payments for Care Improvement (BPCI) Advanced model, extending the deadline from Aug. 1 to Aug. 8. The extension comes after the agency was delayed in the release of claims data, which many providers expected in May, but did not receive until mid- to late-June. The BCPI Advanced model pays providers a fixed price for an episode of care, starting with an initial hospital admission or outpatient procedure and includes care for the next 90 days.

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Disease-modifying antirheumatic drugs (DMARDs) did not offer clinically significant pain relief compared to placebo for patients with osteoarthritis (OA), according to a study published online in the journal Rheumatology. Researchers reviewed Medline, Embase, Allied and Complementary Medicine Database, Web of Science, and Cochrane Library, as well as conference abstracts and ClinicalTrials.gov information to identify randomized, controlled trials (RCTs) of DMARDs and placebo for symptomatic OA published through November 2017. They included 11 RCTs with 1,205 participants, including six with conventional DMARDs (n = 757) and five with biologics (n = 448). DMARDs were statistically superior to placebo, but not clinically significant. The researchers did not observe statistically significant differences in subanalysis of high-quality trials, biologics, or conventional DMARDs.

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CMS proposed significant changes to the Home Health Prospective Payment System, calling for home health agencies to monitor patients remotely. The agency said this will allow doctors to spend more time with patients and give home health agencies leverage to innovate and drive better results. “The redesign of the home health payment system encourages value over volume and removes incentives to provide unnecessary care,” said CMS Administrator Seema Verma. CMS is proposing a 2.1 percent increase ($400 million) in Medicare payments for home health agencies compared to an 0.4 percent reduction ($80 million) in 2017. If approved, the new model would launch Jan. 1, 2020.

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Twenty years ago, many NBA players underwent microfracture surgery, a procedure that involves drilling small holes through the articular cartilage and into the subchondral bone, with the goal of causing stem-cell growth. Articular cartilage is necessary for NBA players, as they can put up to 10 times their body weight on their knees during play. Although the early results of this procedure were promising, many doctors are trending away from the surgery. A study recently published online in the journal Cartilage found that the failure rate of microfracture surgery was 66 percent compared to 51 percent for osteochondral autograft transfer surgery; time to failure for the two procedures was four years and 8.4 years, respectively. An article published in the Chicago Tribune discusses the “rise and fall” of microfracture in the NBA.

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A biologics boom: What are the rules?

Amid the swirl of competing claims about platelet-rich plasma, stem cells, and other biologic therapies stands the orthopaedic surgeon, like a lighthouse, to guide the public and patients who are hoping to benefit from the claims made about these agents. As the physicians who manage conditions for which biologics are commonly heralded as breakthroughs and wonder therapies, orthopaedic surgeons find themselves in roles both of trusted bulwarks separating fact from fantasy and of healing practitioners who welcome new treatments that are proven to benefit their patients. At the AAOS 2018 Annual Meeting, a panel of clinicians and researchers had the task of cutting through the fog for a surgeon audience at a symposium titled “Use and Misuse of Biologics.”

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Act now to nominate future AAOS leadership

The 2019 Nominating Committee is actively soliciting suggestions for individuals to serve in the following positions:

•  Second vice-president
•  Board member-at-large
•  Board member-at-large (< 45 years on March 18, 2019)
•  Nominees to the American Board of Orthopaedic Surgery

Nominations close on Aug. 3. Members can review the position descriptions—including information about responsibilities, desired experience, and time commitments—as well as submit nomination(s) online.

Learn more and submit your nomination…