March 26, 2018 | Today’s News

Omnibus spending bill increases funding to HHS, CDC, and other health agencies

Healthcare IT News reports that an omnibus spending bill passed by the U.S. Congress and signed into law by President Donald J. Trump includes, among other things:

• an additional $10 billion in funding to the U.S. Department of Health & Human Services (HHS)
• an increase of $1.1 billion in funding for the U.S. Centers for Disease Control and Prevention (CDC)
• a nearly 9 percent increase to the National Institutes of Health, including $500 million to research opioid addiction and alternative pain treatments
• an increase in operating budget for the U.S. Agency for Healthcare Research and Quality
• retention of the $60 million operating budget for the Office of the National Coordinator for Health IT

The bill does not include provisions to stabilize Affordable Care Act insurance markets.

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Seven ACOs exit CMS Next Generation ACO Model in wake of changes to risk scoring

Changes made by CMS to the Next Generation ACO Model program are linked to the withdrawal of seven accountable care organizations (ACOs), and at least one is considering legal action, according to Modern Healthcare. CMS lowered the average risk score for 2017 by 4.82 percent, making it more difficult for participating organizations to earn a bonus and avoid a penalty. The agency states that the changes were made to “account for a significant increase in coding intensity that otherwise threatens the financial sustainability of the Next Generation ACO Model.” The publication states that CMS may have been referencing the impact on coding practices of implementing electronic health records and ICD-10 in 2015.

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A study published online in The American Journal of Sports Medicine suggests that treatment with autologous cultured chondrocytes on porcine collagen membrane (MACI) may be more effective than microfracture for the treatment of symptomatic cartilage defects of the knee. The authors conducted a randomized, controlled trial of 128 patients with symptomatic cartilage defects of 3 cm ² or larger, 65 of whom were treated with MACI and 63 of whom were treated with microfracture. At five-year follow-up, they found that patients in the MACI cohort displayed significant improvement in Knee Injury and Osteoarthritis Outcome Score pain and function domains compared to patients in the microfracture cohort. In addition, improvements in activities of daily living were statistically significantly better in MACI patients, and quality of life and other symptoms remained numerically higher in MACI patients but lacked statistical significance compared to a similar analysis at two-year follow-up.

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According to a study published in the April issue of the Journal of Orthopaedic Trauma, malnutrition identified by increasing severity of hypoalbuminemia may be associated with poorer outcomes in the 30 days following hip fracture surgery. The researchers reviewed data on 12,373 patients from the National Surgery Quality Improvement Project. They found that 6,506 patients (52.6 percent) had normal albumin levels (albumin ≥3.5 g/dL), 3,205 (25.9 percent) patients were mildly malnourished (albumin 3.1–3.49 g/dL), 2,265 patients (18.3 percent) were moderately malnourished (albumin 2.4–3.1 g/dL), and 397 patients (3.2 percent) were severely malnourished (albumin <2.4 g/dL). The researchers found that severe malnutrition was associated with a two-fold increase in the odds of postoperative complications and mortality compared with mild malnutrition and increasing severity of malnutrition was associated with significantly longer lengths of stay and higher likelihood of related readmission.

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Findings from study published in the April 1 issue of the Journal of the AAOS suggest that discharge to a postacute care (PAC) facility may be an independent risk factor for complication and readmission after shoulder arthroplasty. Members of the research team reviewed information on 10,660 shoulder arthroplasty procedures from the California Office of Statewide Health Planning and Development discharge database. They found that 7,709 patients were discharged home, 1,858 discharged home with home health support, and 1,093 discharged to PAC facilities. Overall, patients discharged to PAC facilities or to home with health support tended to be older, female, and using Medicare. However, after controlling for confounders, the researchers found that patients who were discharged to PAC facilities were found more likely to experience a complication at 30- and 90-day follow-ups.

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Last call to participate in the 2018 AAOS/OREF/ORS Clinician Scholar Career Development Program

March 31, 2018, is the last day to submit an application to participate in the 2018 AAOS/Orthopaedic Research and Education Foundation (OREF)/Orthopaedic Research Society (ORS) Clinician Scholar Career Development Program (CSCDP). CSCDP is an annual workshop that seeks applicants in years PGY-2 to PGY-5 of orthopaedic residency, fellows, and junior faculty through year three who have the potential and desire to become orthopaedic clinician scientists. Up to 15 AAOS-sponsored participants will be selected to participate in the 1.5-day CSCDP career training program. The 2018 CSCDP will be held Sept. 27–29, 2018, in Rosemont, Ill.

Learn more and submit your application…

AAOS seeks to nominate members to the CMS Technical Expert Panel on Patient-Reported Outcomes Following Elective Total Hip and/or Total Knee Arthroplasty. The primary objective of this project is to develop one to two patient-reported outcome performance measures for Medicare beneficiaries aged 65 years or older who undergo an elective total hip or total knee arthroplasty (THA or TKA). 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 biography, a letter of interest highlighting his or her expertise in the subject area, and a signed CMS nomination form. All supporting materials must be submitted to Kyle Trivedi by April 12, 2018, at 11:59 p.m. CT, at:

trivedi@aaos.org

Learn more and submit your application…  (member login required)

Learn more and obtain the CMS nomination form…