Today’s Top Story
House legislators release ACA repeal plan.
Legislators in the U.S. House of Representatives have released a plan to replace the Affordable Care Act (ACA). The plan is based on five principles:

  • Repeal of the ACA
  • Increased choice, lower costs, and greater flexibility for consumers
  • A rejection of Medicaid expansion in favor of state-based solutions for lower-income patients
  • Legislative efforts to spur innovation in health care
  • Phased improvements to Medicare, including a gradual increase in age of eligibility

Among other things, the proposal also seeks to eliminate the individual mandate, to require insurance coverage for patients with preexisting conditions as long as they have maintained continuous coverage, and to allow states to establish work requirements for able-bodied adults on Medicaid.
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Read the plan (PDF)…
     In related news, a report released this week by the Robert Wood Johnson Foundation and the Urban Institute estimates that cumulative healthcare spending in the United States for 2014 to 2019 may be reduced by approximately $2.5 trillion compared to U.S. Centers for Medicare & Medicaid Services forecasts from 2010. The authors identify several possible causes for the reduction, including the effects of U.S. Supreme Court ACA decisions, sequestration in the Budget Control Act of 2011, and economic factors.
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Read the complete report (PDF)…

Other News

Study: Some hospital readmissions may not be preventable.
Findings published online in the journal JAMA Surgery examine factors associated with hospital readmission and suggest that many readmissions may be unavoidable. The authors reviewed information on 173 patients who had unplanned readmissions within 30 days at a Level 1 trauma center. They found that common causes for readmission included 29 patients with injection drug use who were readmitted with soft tissue infections at new sites, 25 with disposition support issues, 23 with infections not detectable during index admission, and 16 with sequelae of their injury or condition. Overall, 16 patients (9.2 percent) were identified as having a likely preventable complication of care, while two (1.2 percent) were readmitted due to deterioration of medical conditions. On univariate and multivariate analyses, they found that female sex, presence of diabetes, sepsis on admission, intensive care unit stay during index admission, discharge to respite care, and payer status were identified as risk factors for readmission.
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Read the abstract…

Study: What factors are linked to perioperative complication among patients treated surgically for CSM?
A study conducted in Canada and published in the July issue of the journal Neurosurgery examines predictors of perioperative complication for patients with cervical spondylotic myelopathy (CSM). The authors reviewed prospectively collected data on 479 surgical CSM patients and found that 78 experienced a total of 89 perioperative complications. On univariate analysis, they found that major clinical risk factors included ossification of the posterior longitudinal ligament (OPLL), number of comorbidities, comorbidity score, diabetes mellitus, and coexisting gastrointestinal and cardiovascular disorders. In addition, patients who underwent a 2-stage surgery and/or procedure of longer operative duration were at greater risk of perioperative complications. The authors state that their final prediction model consisted of diabetes mellitus, number of comorbidities, operative duration, and OPLL.
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Read the abstract…

Study: Particles released by MOM hip implants may impair MSCs.
Data from a study conducted in Germany and published in the August issue of the journal Biomaterials suggest that the release of cobalt (Co) and chromium (Cr) particles linked to use of metal-on-metal (MOM) hip implants may contribute to bone loss by impairing osteogenic differentiation of mesenchymal stromal cells (MSCs). The researchers assessed in vivo exposure to MoM-wear products to adjacent tissues, joint fluids, and bone marrow, and found that dissolved metal ions reached the bone marrow and decreased MSC osteogenic matrix mineralization and alkaline phosphatase activity on a cellular and systemic level.
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Read the complete study…

Study: Drug industry sponsored meals associated with increased prescribing of promoted drugs.
Findings from a study published online in the journal JAMA Internal Medicine suggest a link between drug industry sponsored meals and increased prescribing of the promoted medication. The authors conducted a cross-sectional analysis of industry payment data from the federal Open Payments Program and compared it against Medicare Part D prescribing data for individual physicians. Overall, 279,669 physicians received 63,524 payments (usually meals) associated with four target drugs—statins, cardioselective β-blockers, angiotensin-converting enzyme inhibitors and angiotensin-receptor blockers, and selective serotonin and serotonin-norepinephrine reuptake inhibitors. The authors found that physicians who received even one meal promoting a drug of interest had higher rates of prescribing that drug compared to alternatives. In addition, the authors note that receipt of additional meals and receipt of meals costing more than $20 were associated with increased relative prescribing rates. The authors write that the findings represent an association, and may not demonstrate a cause-and-effect relationship.
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Read the abstract…

West Virginia.
The Charleston Gazette-Mail reports that the West Virginia Board of Pharmacy is developing a “report card” system to rank physicians based on the number of prescriptions they write for pain medications. The board states that the purpose of the program is educational, and that the report cards won’t be available to the public. Physicians would access only their own numerical ranking as compared to other physicians.
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Submit papers now for 2017 Kappa Delta and OREF Clinical Research Awards.
July 1, 2016 is the deadline for receipt of manuscripts submitted for the 2017 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 2017 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, 2016. Late submissions will not be considered.
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     Submit your manuscript to kappadelta@aaos.org.

Call for volunteers: Candidate, Resident, and Fellow Committee.
Aug. 10 is the last day to submit your application for a position on the Candidate, Resident, and Fellow Committee. The Candidate, Resident and Fellow Committee oversees the Residents’ Newsletter and the Resident Assembly, and addresses all issues concerning residents and candidate members. The following positions are available:

  • Chair
  • Candidate member (one opening)
  • Resident member (one opening)

Applicants for the chair position must be active fellows; applicants for the candidate opening must be candidate members; applicants for the resident opening must be PGY-1, PGY-2, or PGY-3 resident members or resident members osteopathic.
Learn more and submit your application…(member login required)