Today’s Top Story
Supreme Court hears oral arguments in case with potential ACA ramifications.
The U.S. Supreme Court heard oral arguments in King v. Burwell, the outcome of which could place the fiscal foundation of the Affordable Care Act (ACA) in jeopardy. At issue is wording in the healthcare law that plaintiffs claim allows subsidies to insurance purchasers only in states that set up and run their own healthcare exchanges. Attorneys for the Obama administration argue that the law was always intended to subsidize all qualified purchasers, regardless of whether the federal government or the state runs the healthcare exchange. A decision on the case is expected in June. Read more from Medscape
Read more from SCOTUSBlog
   An article in the Associated Press explains the background of the case. Read more…
An article in the Washington Post profiles Republican proposals to address a projected increase in the uninsured, should the Supreme Court rule in favor of the plaintiffs. Read more…

Other News

CMS: First ICD-10 claims testing week saw 81 percent claim acceptance rate.
The U.S. Centers for Medicare & Medicaid Services (CMS) has released data from its recent ICD-10 claims end-to-end testing period. The agency states that it received 14,929 test claims, of which 12,149 (81 percent) were accepted. Overall, 13 percent of claims were rejected for errors unrelated to ICD-10, such as setup issues. In addition, 3 percent of claims were rejected for invalid submission of an ICD-9 diagnosis or procedure code, and 3 percent were rejected for invalid submission of an ICD-10 diagnosis or procedure code. CMS is currently conducting additional ICD-10 claims testing, with another testing week planned for June 1-5, 2015. Physicians who participate in the testing will better able to assess their readiness for ICD-10 implementation and will help CMS prepare for industry-wide use of the code set this fall. Beginning Oct. 1, 2015, all HIPAA-covered entities will be required to submit claims using ICD-10 codes. Read more (PDF)…

Physician demand projected to outpace supply, especially among surgical specialties.
A report from the Association of American Medical Colleges projects a shortfall of 46,100 to 90,400 physicians in the United States by 2025, with the greatest impact among surgical specialties. The authors note that demand for physicians continues to grow faster than supply. Despite modest, projected increases in the number of physicians through 2025, the report projects physician demand to grow by 86,700 to 133,200, with population growth and aging accounting for 14 percent of that growth, and increased demand under the Affordable Care Act responsible for 2 percent. Read more…
Read the complete report (PDF)…

Study: Morbid obesity linked to increased complications among patients with femoral shaft fractures.
According to findings published in the March issue of the Journal of Orthopaedic Trauma, morbid obesity may be a significant risk factor for systemic complications in patients with closed femoral shaft fractures. The authors conducted a retrospective, case-control study of 507 patients with 526 closed femoral shaft fractures treated with reamed intramedullary nailing. Among patients, 184 (36.3 percent) were of normal weight, 170 (33.5 percent) were overweight, 114 (22.5 percent) were obese, and 39 (7.7 percent) were morbidly obese. Overall, systemic complications occurred in 23 percent of morbidly obese patients, compared to 9 percent of normal-weight patients. In addition, morbid obesity was associated with increased likelihoods of mortality, adult respiratory distress syndrome, and sepsis. Read the abstract…

Study examines FAI variants in older men.
Data published online in the journal Clinical Orthopaedics and Related Research examine variations in femoroacetabular impingement (FAI) among older men. The research team reviewed anteroposterior radiographs of 4,140 patients participating in the Osteoporotic Fractures in Men study. They found that pincer, cam, or mixed types of radiographic FAI had a prevalence of 57 percent, 29 percent, and 14 percent, respectively. In addition, both pincer and mixed types of FAI were associated with arthrosis, but not with hip pain. They noted that patients with cam-type FAI had slightly reduced hip pain without the presence of arthrosis, compared against hips without FAI. The research team found that a center-edge angle > 39° and a caput-collum-diaphyseal angle < 125° were associated with arthrosis, but not with hip pain. An impingement angle > 70° was associated with less hip pain compared with hips with an impingement angle ≥ 70°. Read the abstract…

Study: Most TMC OA patients seek treatment for pain relief.
A study published in the March issue of The Journal of Hand Surgery examines factors and outcomes expectations for treatment of trapeziometacarpal osteoarthritis (TMC OA). The researchers surveyed 163 patients with TMC OA and found that 65 percent of patients cited pain reduction as their primary reason for seeking treatment. In addition, 17 percent sought to improve hand function, while 13 percent sought to improve activities of daily living. Overall, no patients considered improved appearance of the hand to be the main reason for undertaking treatment. At 1-year follow-up, the researchers found that 77 percent of surgically treated patients rated their expectations as completely or mostly fulfilled, while the same was true of only 24 percent of patients treated with corticosteroid injections. The researchers argue that, to obtain best treatment results, clinicians should assess patient expectations and explain realistic treatment outcomes prior to treatment. Read the abstract…

2015 Washington Health Policy Fellows announced.
The American Association of Orthopaedic Surgeons (AAOS) has named Youssra Marjoua, MD, MPP, a PGY-5 resident at the Harvard Combined Orthopaedic Residency Program, and Daniel K. Moon, MD, MS, MBA, a PGY-5 resident in the Department of Orthopaedic Surgery at the Washington University School of Medicine, as the 2015 Washington Health Policy Fellows. The Washington Health Policy Fellows program seeks to foster the development of orthopaedic surgeons who are interested in health policy and advocacy. Fellows participate in the development and implementation of cohesive health care policy strategy and are encouraged to develop a strong foundation for leadership. Read more…

Call for volunteers: Program Committees.
April 2 is the last day to submit your application for a position on an AAOS 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 member openings)
  • Adult Reconstruction Knee (12 members)
  • Foot & Ankle (two members)
  • Hand & Wrist (two members)
  • Musculoskeletal Tumor & Metabolic Disease (one member)
  • Pediatrics (five members)
  • Practice Management/Rehabilitation (five members)
  • Shoulder & Elbow (eight members)
  • Spine (five members)
  • Sports Medicine/Arthroscopy (12 members)
  • Trauma (12 members)

Applicants for these positions must be active fellows or international affiliate members with a practice emphasis in the relevant area. Learn more and submit your application…(member login required)