Today’s Top Story
CMS releases provider utilization and payment data.
The U.S. Centers for Medicare & Medicaid Services (CMS) has posted its second annual release of physician and other supplier utilization and payment data. The 2013 physician payment data covers more than 950,000 distinct healthcare providers, includes payment and submitted charges for each provider, and allows for comparisons by physician, specialty, location, types of medical services and procedures delivered, Medicare payment, and submitted charges. The agency has also released Medicare hospital utilization and payment data, including payment and utilization figures for services in connection with the 100 most common Medicare inpatient stays and 30 selected outpatient procedures at over 3,000 hospitals in the United States. Read more…
Access the provider utilization and payment data…
View the hospital inpatient data…
View the hospital outpatient data…

Other News

Study: P. acnes may be common cause of postoperative pain and stiffness in revision shoulder arthroscopy.
Data from a study published in the June issue of the Journal of Shoulder and Elbow Surgery suggest that rates of Propionibacterium acnes infection among patients who undergo revision shoulder arthroscopy may be higher than generally reported, and such infection should be considered in patients with refractory postoperative pain and stiffness. The researchers conducted a prospective study of 1,591 shoulder consecutive shoulder arthroscopies performed at a single center. Of those, 68 were revision procedures performed for pain, stiffness, or weakness. The researchers noted that 20 revision arthroscopies (29.4 percent) had positive culture findings, and of those, 16 (23.5 percent) were positive for P. acnes. In the control group, one patient (3.2 percent) tested positive for P. acnes growth. Read the abstract…

Study: Risk of revision similar for ORIF, primary fusion in treatment of Lisfranc injury.
A study published online in the journal Clinical Orthopaedics and Related Research compares the likelihood of revision for two treatments for Lisfranc injuries. The authors conducted a meta-analysis of three trials that met inclusion criteria and compared the use of open reduction and internal fixation (ORIF) against the use of primary fusion. They found that hardware removal was more likely in ORIF than in fusion procedures (risk ratio 0.23 percent), but for other revision surgery, the risk ratio for ORIF was 0.36, favoring neither. Similarly, neither procedure was favored using patient-reported outcomes or risk of nonanatomic alignment. Read more…

How effective are quality programs?
An article in Modern Healthcare questions the cost-effectiveness of payment programs designed to reward physicians for quality care. The writer states that complex compensation designs, poor alignment of goals, and lack of clearly defined, actionable measures may lead to failed efforts and unintended consequences. In addition, the writer notes that the science of measuring quality performance in health care is new, and improvements seen on easily tracked process measures such as checklist use or giving discharge instructions are not always associated with improvements in patient outcomes. Observers note that quality programs have been linked to improved performance on the part of some providers, but impact is often less than predicted or hoped. Read more…(registration may be required)

CMS proposes changes to make Medicaid and CHIP regulations more consistent with other plans.
HealthLeaders Media reports on changes CMS has proposed to make to Medicaid and the Children’s Health Insurance Program (CHIP). The agency states that the goal of the proposed rule is to better align Medicaid and CHIP regulations to make them more consistent with rules governing commercial, marketplace, and Medicare Advantage plans. The agency is accepting comments on the rule through July 27, 2015. Read more…
Read the proposed rule…

GAO: CMS needs better screening systems to reduce Medicaid fraud.
A report from the U.S. Government Accountability Office (GAO) recommends that CMS issue guidance for screening deceased beneficiaries and supply more data to screen Medicaid providers. GAO reviewed beneficiary and provider enrollment-integrity efforts in Arizona, Florida, Michigan, and New Jersey, and identified thousands of Medicaid beneficiaries and hundreds of providers who may have been involved in improper or fraudulent payments during fiscal year 2011—the most-recent year for which reliable data were available. The agency found that about 8,600 beneficiaries had payments made on their behalf concurrently by two or more of the selected states, totaling at least $18.3 million. Further, about 200 deceased beneficiaries received about $9.6 million in Medicaid benefits, and about 50 providers were excluded from federal healthcare programs for a variety of reasons including patient abuse or neglect, fraud, theft, bribery, or tax evasion. Read more…

Submit papers now for Kappa Delta and OREF Clinical Research Awards.
July 1, 2015 is the deadline for receipt of manuscripts submitted for the 2016 Kappa Delta Awards and the Orthopaedic Research and Education Foundation (OREF) Clinical Research Award. Up to two $20,000 Kappa Delta awards (Elizabeth Winston Lanier Award and Ann Doner Vaughan Award), one $20,000 Kappa Delta Young Investigator award, and one $20,000 OREF award will be bestowed, provided manuscripts of requisite quality are submitted. Manuscripts should represent a large body of cohesive scientific work, generally reflecting years of investigation. If the submission reflects a single project, it should be of high significance and impact. Manuscripts must be submitted by members (or candidate members) of the AAOS, Orthopaedic Research Society, Canadian Orthopaedic Association, or Canadian Orthopaedic Research Society. Submissions for the 2016 Kappa Delta and OREF Clinical Research Awards will be accepted in electronic format only. A PDF of the entire submission must be emailed no later than 11:59 p.m. CT on July 1, 2015. Late submissions will not be considered. Read more…
Submit your manuscript to: kappadelta@aaos.org.

Call for volunteers: Judiciary Committee.
June 30 is the last day to submit your application for a position on the Judiciary Committee (two member openings). The Judiciary Committee reports directly to the AAOS Board of Directors, is responsible for hearing and adjudicating appeals of the Committee on Professionalism Grievance Hearing Panel’s reports, and makes recommendations regarding complaints against AAOS members for alleged violations of the AAOS Standards of Professionalism. Applicants for this position must be active or emeritus fellows with a demonstrated understanding of and experience with legal issues related to orthopaedic surgery, including orthopaedic expert opinion and testimony. Learn more and submit your application…(member login required)