Today’s Top Story
Is a “real” SGR fix in the works?
The Hill reports that the U.S. House of Representatives is considering a bipartisan agreement to permanently repeal and replace the Medicare Sustainable Growth Rate (SGR) formula. Previous talks to eliminate the SGR have broken down when lawmakers were unable to agree on how to pay for it, as current House rules call for increases in spending to be offset by increases in revenue or cuts elsewhere. However, observers say the current deal would only partially offset the estimated $174 billion cost of repeal, which could make it easier to move forward. The SGR currently calls for a greater than 20 percent reduction in physician reimbursement to take effect April 1. Read more…
Read the statement from the House Energy and Commerce Committee…
Read more in AAOS Advocacy Now…

Other News

Study: Direct anterior and anterolateral surgical approaches may reduce risk of dislocation for primary THA.
Data published online in the journal Clinical Orthopaedics and Related Research suggest that the use of direct anterior and anterolateral surgical approaches for primary total hip arthroplasty (THA) may be associated with reduced risk of dislocation compared to posterior and direct lateral approaches. The authors reviewed registry data on 42,438 primary THAs that were available for analysis of revision outcomes and 22,237 for dislocation. The most commonly used approaches were posterior (75 percent), anterolateral (10 percent), direct anterior (4 percent), and direct lateral (2 percent). During the study period, 785 hips (2 percent) were revised for aseptic reasons; 213 hips (0.5 percent) were revised for septic reasons; and there were 276 dislocations (1 percent). The authors found no difference in adjusted risk of revision across different THA approaches. However, anterolateral approach and direct anterior approach were associated with a lower risk of dislocation relative to the posterior approach. Read the abstract…

FDA announces new recommendations for safe and effective use of reprocessed devices.
The U.S. Food and Drug Administration (FDA) has outlined new recommendations for medical device manufacturers to enhance the safe and effective use of reprocessed devices. The guidance lists six criteria to be addressed in the instructions for use with every reusable device, i to ensure users understand and correctly follow the reprocessing instructions. The guidance also recommends that manufacturers consider reprocessing challenges early in device design. In addition, manufacturers will be expected to conduct validation testing to show with a high degree of assurance that their cleaning and disinfection or sterilization instructions will consistently reduce microbial contamination. The recommendations are being released in the wake of reports of infection transmission associated with the use of duodenoscopes in endoscopic retrograde cholangiopancreatography procedures. Read more…
Read the FDA statement…
Read the complete guidance document (PDF)…

Analysts say healthcare spending grew 5.4 percent during 2014.
According to Bloomberg Business, an analysis of federal data conducted by private economists suggests that healthcare spending increased about 5.4 percent from the previous year. Until 2009, healthcare spending generally increased about 6 percent each year. However, from 2009 to 2013, spending on health care remained stable at about 17.4 percent of the U.S. economy—a trend attributed at least in part to the economic recession. Observers say that the finding may be indicative of a trend toward accelerating costs during 2015. Read more…
Read the report (PDF)…

FDA announces consent decree with compounding pharmacy linked to bacterial infections.
A consent decree of permanent injunction has been entered against Specialty Compounding LLC, of Cedar Park, Texas. According to the complaint filed with the consent decree, Specialty Compounding manufactured purportedly sterile injectable drug products that tested positive for bacterial contamination. In August 2013, FDA received reports from two Texas hospitals that 17 patients had developed bacterial bloodstream infections after receiving an infusion of the drug calcium gluconate manufactured by Specialty Compounding. Specialty Compounding ceased sterile drug manufacturing operations in August 2013, and recalled all lots of its unexpired sterile drug products distributed since February 1, 2013. An FDA inspection found insanitary conditions and numerous violations of the current good manufacturing practice requirements for drug products. Under terms of the consent decree, Specialty Compounding and its owners are prohibited from manufacturing, holding, or distributing sterile drugs until they comply with the Federal Food, Drug, and Cosmetic Act and its regulations, in addition to other requirements. Read more…

Oregon.
KGW—Portland reports that a bill under consideration in the Oregon State Senate would, if enacted, increase cost transparency for medical procedures in the state. The bill contains three elements:

  • A website that would list median prices for common hospital procedures
  • A commitment from insurance companies to help consumers with out-of-pocket expenses
  • Up-front cost estimates from hospitals for people who pay for their own procedures

The bill currently has 10 sponsors in the legislature and bipartisan support. Read more…

Can’t attend the AAOS Annual Meeting? Online webcasts will bring symposia to you.
AAOS Annual Meeting symposia explore some of the hottest topics in orthopaedics, presented by some of the top experts in their field. Register now to view 11 symposia webcasts from the upcoming AAOS Annual Meeting in Las Vegas. The symposia will be streamed live from the Annual Meeting, with on-demand viewing available the day after the symposium and running through June 30, 2015. The webcasts are free to AAOS members. Register online…

Call for volunteers: CMS Pain Management/Throughput Measure Expert Group.
AAOS seeks to nominate a member to the serve on a U.S. Centers for Medicare & Medicaid Services (CMS) expert panel for pain management and throughput measures. CMS is working to develop and maintain a set of clinical quality measures for use of reporting by hospital emergency departments. The intent is to support CMS efforts to help Medicare beneficiaries make more informed decisions about their health care, and to evaluate the regularity with which a healthcare provider administers the outpatient treatment known to provide the best results for most patients with a particular condition. Applicants for this position must be active fellows, candidate members, candidate members osteopathic, candidate member applicants for fellowship, or candidate member applicants for fellowship osteopathic. In addition, all applicants must provide the following: an online AAOS CAP application, a current curriculum vitae, a 100-word biosketch, and a letter of interest highlighting his or her expertise in the subject area and a statement that he or she is able to participate in full capacity. All supporting materials must be submitted by Wednesday, March 11, 2015 at 11:59 p.m. CT, to Kyle Shah at shah@aaos.org.
Learn more and submit your application…(member login required)