Today’s Top Story
Details emerge on SGR proposal.
According to the Associated Press, a document circulating among lawmakers discloses details about a $213 billion proposal that, if enacted, would repeal the Medicare Sustainable Growth Rate (SGR) formula. Details include the following:

  • About $35 billion would be paid for by increasing costs to some beneficiaries, including higher Medigap costs and raising premiums on beneficiaries who earn more than $133,000 per year.
  • An additional $35 billion in savings would come from Medicare providers (likely post-acute care) and hospitals.
  • Physicians would receive an annual 0.5 percent payment increase for the first 5 years, followed by incentives to shift to a pay-for-performance system in place of the current fee-for-service approach.

Read more…
Read more in AAOS Advocacy Now…
Visit the AAOS SGR advocacy page…

Other News

House budget seeks to repeal ACA; partly privatize Medicare.
The New York Times reports that a budget proposal released by the U.S. House of Representatives seeks to, among other things, repeal the Affordable Care Act (ACA). The final bill is expected to include parliamentary language that would allow the legislation to pass the Senate with a simple majority. However, the bill would still be subject to presidential veto. In addition, the proposal would partially privatize Medicare, with future recipients offered voucherlike “premium support” to help pay for private insurance instead of government-provided care, and cut spending on Medicaid over 10 years, with the funding rechanneled into block grants to state governments. Read more…

Appeals court decision could delay CMS RAC program.
A post on the California Medical Association’s website looks at a decision by the U.S. Court of Appeals for the Federal Circuit that will likely put the Centers for Medicare and Medicaid Services (CMS) Recovery Audit Contractor (RAC) program temporarily on hold. Since the RAC program started in 2008, RACs have been paid immediately after Medicare overpayments are collected from providers, usually within 41 days. In 2014, CMS proposed paying on collections only after a provider’s challenge passed the second of a five-level appeal process. One RAC filed suit, arguing the new payment terms violated federal procurement law and asked the court to compel CMS to procure new contracts through a request-for-proposal process instead of more straightforward commercial bidding. The court agreed, and CMS must now either rebid contracts with RACs through the general commercial process with the original contingency fee structure, or through a longer noncommercial process with the new payment terms. Observers say this will likely cause a significant delay, because the new contracts are not expected to be finalized until early 2016. Read more…

Study: S. Aureus forms biofilms even in antibiotic-enriched synovial fluid.
Data published online in the journal Antimicrobial Agents and Chemotherapy suggest that even high concentrations of antibiotics in synovial fluid may not eradicate Staphylococcus aureus during total joint arthroplasty. The research team introduced S. aureus into synovial fluid containing high levels of cefazolin. They found that S. aureus was not eradicated, and was even able to form biofilms and colonize model implant surfaces such as titanium pins. Read more…
Read the abstract…

Study: Early imaging may not improve outcomes for older patients with new back pain.
According to a study published in the March 17 issue of The Journal of the American Medical Association, early imaging may not be linked to improved 1-year outcomes for older adults with back pain. The authors conducted a prospective cohort study of 5,239 patients 65 years or older with new back pain who were seen by primary care physicians. Overall, 1,174 had early radiographs and 349 had early magnetic resonance imaging (MRI) or computed tomography (CT) scans. At 12-month follow-up, neither the early radiograph group nor the early MRI/CT group differed significantly from controls on Roland-Morris Disability Questionnaire. The mean score for patients who underwent early radiography was 8.54, compared to 8.74 among the control group. The mean score for early MRI/CT group was 9.81, compared to 10.50 for the control group. Read more…
Read the abstract…

Vote now for 2015 AAOS leadership!
Online voting is now open on the AAOS website. Voting will be available until 1 p.m. PDT on Wednesday, March 25, with the results of the balloting announced on Thursday, March 26, during the 2015 Association business meeting at the AAOS Annual Meeting. The new leaders will take office at the conclusion of the 2015 Annual Meeting. The 2015 Nominating Committee has identified and announced the following candidates for the named positions:

  • Second Vice-President: William J. Maloney, MD (Calif.)
  • At-Large Member of Board of Directors (no age designation): Howard R. Epps, MD (Texas)
  • At-Large Member of the Board of Directors (under age 45): Daniel C. Farber, MD (Pa.)
  • Member of the National Membership Committee: Robert M. Orfaly, MD (Ore.)
  • Four nominees to the American Board of Orthopaedic Surgery (ABOS):
    • Joshua J. Jacobs, MD (Ill.)
    • Keith Kenter, MD (Ohio)
    • Gregory A. Mencio, MD (Tenn.)
    • Dean C. Taylor, COL, MD (N.C.)

Submit your ballot…(member login required)

Apply now for the 2015 AAOS/OREF/ORS Clinician Scholar Career Development Program.
March 31 is the last day to submit your application to participate in the Clinician Scholar Career Development Program (CSDP). The program is a joint project of AAOS, the Orthopaedic Research and Education Foundation (OREF), and the Orthopaedic Research Society (ORS). CSDP seeks applicants in years PGY2 to PGY5 of orthopaedic residency, fellows, and junior faculty through year 3 who have the potential and desire to become orthopaedic clinician scholars (scientists and investigators). Up to 15 applicants will be selected to participate in the 1.5-day training workshop, with up to 10 additional participants sponsored by orthopaedic specialty societies. The 2015 AAOS/OREF/ORS CSDP will take place Sept. 17-19, 2015, in Rosemont, Ill. Please submit applications, along with curriculum vitae and a letter of support, by 11:59 PM CST on March 31, 2015 to csdp@aaos.org.
Learn more and submit your application…

Call for volunteers: CMS Development and Reevaluation of Outpatient Imaging Efficiency Technical Expert Panel.
AAOS seeks to nominate members to the CMS Development and Reevaluation of Outpatient Imaging Efficiency Technical Expert Panel. The goal of the panel is to contribute direction and thoughtful input regarding Outpatient Imaging Efficiency measures for CMS quality reporting programs. Such measures are intended to reduce unnecessary exposure to testing or treatment that risk downstream patient harm, ensure adherence to evidence-based practice guidelines, and promote efficiency by reducing waste. 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, a conflict of interest disclosure form, 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 Sunday, March 22, 2015 at 11:59 p.m. CT, to Kyle Shah at: shah@aaos.org.
Learn more and submit your application…(member login required)