Today’s Top Story
Senators call for CHIP funding to be included in SGR repeal package.
The Associated Press reports that some U.S. senators may be threatening to oppose a bipartisan deal to eliminate the Medicare Sustainable Growth Rate (SGR) formula currently under discussion in the U.S. House of Representatives, unless the bill includes 4 years of funding for the Children’s Health Insurance Program (CHIP). Observers say that House lawmakers have discussed funding CHIP for 2 years as part of the legislative package. Funding for CHIP is set to expire Oct. 1, 2015. The SGR currently calls for a greater than 20 percent cut to physician reimbursement under Medicare starting April 1. Read more…
    In a letter to Speaker Boehner, the American Association of Orthopaedic Surgeons and more than 750 other medical organizations called for repeal of the SGR “before the expiration of the current payment patch.” Read more…
Read more in AAOS Advocacy Now…

Other News

Study: PRP may help heal rotator cuff tears, but isn’t cost effective.
Findings from a meta-analysis published online in The American Journal of Sports Medicine (AJSM) suggest that use of platelet-rich plasma (PRP) may help promote healing of small- and medium-sized rotator cuff tears and reduce retear rates after arthroscopic treatment, yet its use may not be cost-effective. The research team analyzed 13 studies covering a total of 778 rotator cuff tears. Subgroup analysis of small/medium tears (n = 404) and large/massive tears (n = 374) found that, for small- and medium-sized tears (<3 cm), the risk ratio for retear favored the use of PRP. However, at an incremental cost-effectiveness ratio of US$127,893 per quality-adjusted life year gained, the use of PRP was not determined to be cost-effective for those tears. Read the abstract…

MedPAC recommendations include repealing SGR, reducing pay differences between primary care and specialty services.
The U.S. Medicare Payment Advisory Commission (MedPAC) has released its March 2015 Report to the Congress: Medicare Payment Policy, which includes the agency’s recommendations for 2016 rate adjustments in fee-for-service (FFS) Medicare. Recommendations in the report include:

  • Repealing the SGR system and replacing it with a 10-year path of statutory fee-schedule updates, including a higher payment rate update for primary care services than for specialty services.
  • Reducing or eliminating the differences in payment rates between outpatient departments and physician offices for selected ambulatory services.
  • Increasing the shared savings opportunities for physicians and health professionals who join or lead “two-sided risk” accountable care organizations.
  • Increasing payment rates for acute care hospital inpatient and outpatient prospective payment systems in 2016.

Read the press release (PDF)…
Read the fact sheet (PDF)…
Read the executive summary of the report (PDF)…

Study: Surgical simulator may help improve resident arthroscopy performance.
According to a study published online in AJSM, use of a surgical simulator may help improve the arthroscopic performance of orthopaedic surgery residents compared to didactic training. The researchers conducted a randomized study of 14 junior orthopaedic surgery residents at a single institution who received training in knee and shoulder arthroscopy with either a surgical simulator (n = 8) or didactic lectures with arthroscopy models (n = 6). Residents were assessed using a cadaveric model. For shoulder arthroscopy, the researchers found that residents in the surgical simulator cohort outperformed the didactic-trained residents in time to completion and injury grading index. In addition, the researchers noted similar trends toward improved performance of knee arthroscopy by the simulator-trained group compared to those in the control group. Read the abstract…

Congress to consider IPAB repeal.
American Medical News reports that two counterpart bills under consideration in the U.S. House and Senate would, if enacted, repeal the Independent Payment Advisory Board (IPAB)—a federal panel created by the Affordable Care Act and charged with reducing healthcare spending. The bills have bipartisan support. Some experts compare IPAB unfavorably to the SGR as “arbitrary and rigid” systems that “rely solely on payment cuts” to control costs. Read more…
Read the AAOS position statement on Principles for Physician Payment Reform…

Study: Lumbar decompression for DLSS may offer improved quality of life even to older patients.
According to data from a Swiss study published in the March 15 issue of the journal Spine, lumbar decompression for symptomatic degenerative lumbar spinal stenosis (DLSS) may improve quality of life for patients 80 years and older. The authors conducted a prospective, multicenter study of 37 patients treated with lumbar decompression surgery at an average age of 82.5 years. At 6- and 12-month follow-up, they noted significant improvement in Spinal Stenosis Measure (SSM) scores, Feeling Thermometer, Numeric Rating Scale, and Roland and Morris Disability Questionnaire. Overall, 70 percent of patients achieved the minimal clinically important difference for the Symptom Severity scale in the SSM. Read the abstract…

Study: Many clinical trials fail to report data within mandated time-frame.
Findings published in the March 12 issue of The New England Journal of Medicine suggest that many clinical trials fail to report results to ClinicalTrials.gov in a timely fashion, despite federal mandates to do so. The authors identified 13,327 clinical trials considered likely to be subject to federal reporting requirements. They found that only 13.4 percent of the trials reported summary results within 12 months of trial completion. The authors noted that timely reporting was independently associated with U.S. Food and Drug Administration oversight, a later trial phase, and industry funding. Read more…(registration may be required)
Read the complete study…

Call for volunteers: AMA Pain Management CME.
AAOS seeks to nominate one member to serve as the AAOS representative and expert panelist to assist in developing a new, interactive continuing medical education (CME) product on pain management. The CME will have some emphasis on responsible opioid prescribing and reducing harms attributable to opioid use and misuse. 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 18, 2015 at 11:59 p.m. CT, to Kyle Shah at shah@aaos.org.
Learn more and submit your application…(member login required)