Today’s Top Story

CMS unveils CHIP and Medicaid transparency scorecard

The Centers for Medicare & Medicaid Services (CMS) released the first Medicaid and Children’s Health Insurance Program (CHIP) Scorecard as part of an effort to increase transparency and accountability, and to offer insights into how their dollars are spent and the impact on health outcomes. The first version of the scorecard includes measures such as state health system performance, state administrative accountability, and federal administrative accountability, as well as child visits, mental health conditions, children’s preventive dental services, and other chronic health conditions. The agency said the scorecard will be updated annually with new functionality and metrics, including opioid-related and home- and community-based services-related quality metrics, as well as a comparison of spending patterns.

Read the press release from CMS…

Other News

CMS says MIPS program exceeds participation goal

CMS reports that 91 percent of all clinicians eligible for the Merit-based Incentive Payment System (MIPS) participated in the first year of the program, exceeding the agency’s goal of 90 percent participation. CMS Administrator Seema Verma also highlighted that submission rates for accountable care organizations and clinicians in rural practices were 98 percent and 94 percent, respectively. The agency will use MIPS performance data to adjust providers’ Medicare reimbursement starting Jan. 1, 2019, and data for the first year was due Apr. 3. Eligible physicians who did not participate in MIPS face penalties, including a 4 percent cut in Medicare reimbursement Last year, some providers expressed concern over the MIPS deadlines due to technical difficulties and lack of information on program requirements. The agency said it is making changes to reduce the regulatory burden under MIPS to further increase participation.

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Study: Physician supervision may not reduce medical errors among resident teams

A randomized trial published online in JAMA Internal Medicine found that the medical error rate among inpatient resident teams did not appear to be significantly improved with increased attending physician supervision. The 9-month clinical trial was performed on an inpatient general medical service of a large academic medical center and included clinical teaching attending physicians and residents involved in an internal medicine residency program. Twenty-two faculty provided either increased direct supervision in which attending physicians joined work rounds on previously admitted patients or provided standard supervision in which attending physicians were available but did not join work rounds. The study included 1,259 patients (5,772 patient-days). Interns reportedly spoke less when an attending physician joined rounds and reported feeling less efficient and less autonomous when an attending physician was present. Residents also reported feeling less autonomous with increased supervision.

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Study identifies factors associated with functional outcomes and quality of life after subtalar fusion

Smoking, complications after fusion (such as nonunion, implant failure, and infectious complications), high-energy trauma, and presence of ipsilateral injuries were independently associated with worse functionality and quality of life in patients undergoing subtalar fusion for post-traumatic subtalar arthritis after calcaneal fracture, according to a retrospective study published online in Foot & Ankle International. The study included 159 patients who underwent the procedure at two Level I trauma centers between 2001 and 2016. Patients also completed a survey consisting of the Foot and Ankle Ability Measure, Maryland Foot Score, Patient-Reported Outcomes Measurement System Physical Function questionnaire, EuroQol 5-dimensional questionnaire, and EuroQol visual analog scale. A total of 84 patients (59 percent) completed the questionnaires. Researchers observed acceptable functional outcomes and quality of life in patients who underwent subtalar fusion; however, quality of life was significantly lower compared to a reference population.

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Study: Redislocation rate following lateral patellar dislocation repair appears to be significantly lower with arthroscopic-assisted repair compared to a knee brace

A study published online in The American Journal of Sports Medicine appeared to show that surgical repair of a medial patellofemoral ligament (MPFL) injury in the acute phase in skeletally immature children with a primary traumatic lateral patellar dislocation (LPD) significantly reduced the redislocation rate but did not improve subjective or objective knee function compared to a knee brace without repair. This prospective series followed 74 patients (mean age, 131 years) with a first-time traumatic LPD who underwent clinical examinations, radiographs, magnetic resonance imaging, and diagnostic arthroscopic surgery within two weeks of the index injury. Children were randomized to receive a knee brace for four weeks and physical therapy, or arthroscopic-assisted repair of the MPFL with anchors, four weeks with a soft cast splint, and physical therapy. After two years of follow-up, the redislocation rate was significantly lower in the arthroscopic-assisted repair group (n = 8, 22 percent) versus the knee brace group (n = 16, 43 percent). However, the majority of patients in both cohorts were reportedly satisfied with knee function. Researchers said there was a high representation of anatomic patellar instability risk factors in the cohort, which should be considered when evaluating the risk of redislocations.

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Study: Mixing of some surgical antiseptics may produce toxic products

A study that observed the reactions that occur when commonly used surgical antiseptics are mixed found that at least two of the reactions tested—chlorhexidine + Dakin’s solution (sodium hypochlorite) and Dakin’s solution + hydrogen peroxide—yielded byproducts that are potentially toxic to human beings. The findings were presented in Scientific Poster 696 at the AAOS 2018 Annual Meeting.

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Apply for Adult Spine Evaluation Committee member position

The AAOS Adult Spine Evaluation Committee has an open member position, a three-year term that runs from Mar. 18, 2019, to Mar. 25, 2022. The committee prepares the Adult Spine Self-Assessment Examination and acts as a resource as requested for providing examination questions for other AAOS educational programs. The last day to submit an application is Aug. 3.

Learn more and submit your application… (member login required)