Today’s Top Story
CMS delays SHFFT implementation to Oct. 1.
Modern Healthcare reports that the U.S. Centers for Medicare & Medicaid Services (CMS) has issued an interim final rule that delays implementation of the Surgical Hip and Femur Fracture Treatment (SHFFT) model from July 1 to Oct. 1, 2017. The rule will be published in the Federal Register on March 21. Read more…(registration may be required)
Read the rule…
Other News
MedPAC report agrees with specified payment increase to physicians in 2018; no increase for ASCs.
The Medicare Payment Advisory Commission (MedPAC) has issued its March 2017 Report to the Congress: Medicare Payment Policy. The report includes the agency’s analyses of payment adequacy in fee-for-service Medicare and provides a review of Medicare Advantage and Part D. Among other things, MedPAC recommends that payments to physicians and hospitals be increased by the amount specified in current law during 2018. However, the agency recommends no payment increase for 2018 for ambulatory surgical centers (ASCs) or long-term care hospitals, and a 5 percent reduction in payments for home health agencies and inpatient rehabilitation facilities. The agency writes that the recommendations “are expected to reduce spending in the Medicare program without harming beneficiaries’ access to care.” Read more (PDF)…
Read the report (PDF)…
Study: Home-based rehabilitation may be preferred for certain TKA patients.
Findings from a study conducted in Australia and published in the March 14 issue of The Journal of the American Medical Association suggest that a monitored, home-based rehabilitation program may be as effective as inpatient rehabilitation for patients who undergo uncomplicated total knee arthroplasty (TKA). The authors conducted a randomized trial of 165 patients who received inpatient hospital rehabilitation and home-based rehabilitation (n = 81) or home-based rehabilitation alone (n = 84), and 87 nonrandomized patients enrolled in an observation group, which included only the home-based program. At 26-week follow-up, the authors found no significant difference between the three cohorts in a 6-minute walk test, Oxford Knee Score, or EuroQol Group 5-Dimension Self-Report Questionnaire. Read the abstract…
Study: Sagittal spinal deformity may increase risk of THA instability.
According to a study published online in The Journal of Arthroplasty and presented at the AAOS Annual Meeting, patients with spinal deformity who undergo total hip arthroplasty may be at increased risk of THA instability, despite having an acetabular cup position generally considered within acceptable alignment. The researchers used standing stereoradiography to evaluate spinopelvic parameters, acetabular cup anteversion, and inclination of 139 THAs among 107 patients with sagittal spinal deformity. They found that the rate of THA dislocation was 8.0 percent, with a revision rate of 5.8 percent for instability. Overall, patients who sustained dislocations had significantly higher spinopelvic tilt, T1-pelvic angle, and mismatch of lumbar lordosis and pelvic incidence. Among all patients, 78 percent had safe anteversion while supine, which decreased to 58 percent when standing due to increases in spinopelvic tilt. Among dislocated THAs, the researchers found that 80 percent had safe anteversion, 80 percent had safe inclination, and 60 percent had both parameters within the safe zone. Read more…
Read the abstract…
CDC: Opioid dependence can begin 3 days into initial prescription.
A report from the U.S. Centers for Disease Control and Prevention (CDC) states that the likelihood of a patient becoming dependent on opioids begins to increase after the third day supplied and rises rapidly thereafter. The writers note that CDC guidelines call for treatment of acute pain with opioids to be for the shortest durations possible. “Prescribing <7 days (ideally ≤3 days) of medication when initiating opioids could mitigate the chances of unintentional chronic use,” they write. “When initiating opioids, caution should be exercised when prescribing ≥1 week of opioids or when authorizing a refill or a second opioid prescription because these actions approximately double the chances of use 1 year later. In addition, prescribers should discuss the long-term plan for pain management with patients for whom they are prescribing either Schedule II long-acting opioids or tramadol.” Read more…
NRMP Match Day largest ever; orthopaedics remains highly competitive.
The National Resident Matching Program (NRMP) has released the results for Match Day 2017. Among other things, 1,013 applicants applied for 727 positions in orthopaedics, across 165 programs. NRMP states that specialties with more than 30 positions that achieved the highest percentages of positions filled by U.S. allopathic seniors—considered to be a measure of competitiveness—were integrated plastic surgery (93.1 percent), orthopaedic surgery (91.9 percent), and otolaryngology (91.5 percent). Read more…
Call for volunteers: Program Committees.
March 31 is the last day to submit your application for a position on a Program Committee. Members of Program Committees grade symposia in May and abstracts in June and July, and may serve as moderators for paper sessions at the AAOS Annual Meeting. The following openings are available:
- Adult Reconstruction Hip (five members)
- Adult Reconstruction Knee (five members)
- Practice Management/Rehabilitation (three members)
- Spine (one member)
Applicants for these positions must be active or international fellows with a practice emphasis in the relevant area. Learn more and submit your application…(member login required)
