Today’s Top Story
President discusses healthcare reform at joint session of Congress.
Speaking to a joint session of the U.S. Congress, President Trump offered a broad outline for repeal and replacement of the Affordable Care Act (ACA). As reported by Medscape, key priorities include:

  • Access to healthcare coverage for consumers with pre-existing conditions
  • A stable transition for consumers who have purchased insurance through ACA exchanges
  • Tax credits to purchase coverage along with expanded use of health savings accounts
  • More control of Medicaid shifted to the states
  • Sale of health insurance across state lines

The president also argued in favor of reduced regulation by the U.S. Food and Drug Administration to reduce the time it takes to bring new drugs to market. Read more…(registration may be required)
An article in Politico notes that Senate Majority Leader Mitch McConnell (R-Ky.) has called a meeting of Republican senators to discuss the “upcoming mark-up of the [U.S. House of Representatives] Repeal and Replace bill.” Read more…

Other News

House bill seeks to cap noneconomic damages in certain medical liability suits.
According to Medscape, a bill approved by the House Judiciary committee and now under consideration in the U.S. House of Representatives would, if enacted, cap noneconomic damages in medical liability suits at $250,000, but only if the plaintiffs received health care through a federal program, subsidy, or tax benefit, such as Medicare, Medicaid, subsidized plans under the ACA, and employer-sponsored health plans. The bill would also:

  • Limit contingency fees of plaintiffs’ attorneys
  • Require damages of $50,000 or more to be paid in installments
  • Exempt clinicians who order a drug or medical device for a patient from product liability or class action suits
  • Require recoverable damages among multiple defendants to be based on their percentage of responsibility
  • Reduce the statute of limitations for medical liability suits to 3 years after date of injury, or 1 year after discovery of injury, whichever comes first

Supporters of the bill say that the caps will reduce the practice of defensive medicine and ensure efficient spending of federal funds. Read more…(registration may be required)

Study: Hip fracture linked to increased risk of all-cause mortality for 8 years or more.
Data from a study published online in the Journal of Internal Medicine suggest that hip fracture may be associated with increased risk of all-cause mortality in both the short- and longer-term. The authors reviewed information on 122,808 participants from eight cohorts in Europe and the United States. At mean 12.6-year follow-up, they noted 4,273 incident hip fractures and 27,999 deaths. After adjustment, they found that hip fracture was positively associated with increased all-cause mortality during the first year, but also through 8 or more years. The association was stronger among men than women, although the difference was not significant. Read more…
Read the abstract…

Study: Insurers may pay premium price to hospitals for hip and knee implants.
A research letter published in the Feb. 28 issue of The Journal of the American Medical Association (JAMA) finds that some hospitals may charge private insurers double the typical cost for knee and hip implants. The research team reviewed claims data from a single insurer on 40,372 patients who underwent primary total knee arthroplasty and 23,570 patients who underwent primary total hip arthroplasty. They found that the average selling price (ASP) to hospitals for knee implants was $5023.01, while the mean insurance payment was $10,604.52. Similarly, the ASP for hip implants was $5619.75 and the mean insurance payment was $11,751.25. Read more…
Read the research letter…

International groups update guidelines on management of sepsis.
The European Society of Intensive Care Medicine and the Society of Critical Care Medicine have updated their Surviving Sepsis Guidelines. The updated guidelines, which were developed by 55 international experts representing 25 international organizations, include 93 recommendations on early management of sepsis and septic shock. According to an article in the Feb. 28 JAMA, among the topics covered, sections on initial resuscitation and antibiotic therapy have seen the most important changes in this recent update. Read more…
Read a synopsis of the guidelines…
Read the complete guidelines…

Study: Public often unaware of practice of overlapping surgery; most would prefer to be informed.
Findings from a survey published online in the Journal of the American College of Surgeons suggest that a small minority of the general public is aware of the practice of overlapping surgery, and most would prefer that the practice be disclosed during the informed consent process. The researchers surveyed 1,454 people and found that only 56 (3.9 percent) had prior knowledge of the practice of overlapping surgery. Overall, 31 percent of respondents supported or strongly supported the practice. However, 94.7 percent said that the attending surgeon should inform them of the practice in advance. Read more…
Read the abstract…

Call for volunteers: Instructional Course Committees.
March 31 is the last day to submit your application for a position on an Instructional Course Committee. Members of Instructional Course Committees grade Instructional Course Lecture applications in May and provide input to the Central Instructional Courses Committee regarding course curricula at the AAOS Annual Meeting. The following openings are available:

  • Pediatrics (one member)
  • Spine (four members)
  • Tumor (two members)

Applicants for these positions must be active fellows with a practice emphasis in the relevant area. Learn more and submit your application…(member login required)