Today’s Top Story
1. Health insurance companies join fight against opioid abuse.
Health insurance companies are taking measures to combat the growing opioid epidemic in the United States, targeting the overprescribing of prescription painkillers such as oxycodone, hydrocodone, and morphine, CNN reports. To reduce the number of opioid prescriptions written, Cigna plans to flag customers they deem high risk for abuse—those who are prescribed large amounts of opioid medications, get narcotic prescriptions from more than one doctor, or take these medications for long periods of time—and contact their physicians. Aetna and Blue Cross Blue Shield have already instituted similar measures. According to a leading expert on opioid addiction, actions such as these may make a large impact due to the financial role insurance companies play in health care.
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Other News

CMS considers potential benefits of adding unique device identifiers to claims data.
The Centers for Medicare & Medicaid Services (CMS) is working with the U.S. Food and Drug Administration (FDA) to possibly include unique identifiers for medical devices in insurance claims forms, reports Modern Healthcare. The idea “has merit, particularly from a research perspective,” said CMS Acting Administrator Andy Slavitt, while testifying in front of the House Ways and Means Subcommittee on Health regarding the Medicare Access and CHIP Reauthorization Act. In the past, CMS has indicated concerns about the costs and complexity of the technology required to add unique medical device identifiers to insurance forms. Although Mr. Slavitt acknowledged that training and funding would be required, he did not indicate these factors would make it impossible to move forward with the change.
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Study: Traveling clinic visits by orthopaedic surgeons improve rural access to care.
Patients in rural areas of Iowa gained increased access to orthopaedic care through visiting consultant clinics (VCCs) staffed by orthopaedic surgeons who traveled to these sites from their regular practice locations, a study in the Journal of Bone & Joint Surgery reports. In 2014, traveling orthopaedic surgeons—representing 45 percent of orthopaedists in the state—traveled about 32,000 miles per month to 80 predominantly rural VCC sites, providing 4,596 clinic days. The result was an increase in the number of Iowa counties with an orthopaedic surgeon presence (primary practice or VCC) from 35 to 88 counties out of 99, increasing access to orthopaedic surgeons for as many as 670,000 Iowa residents out of 3 million. Driving distance to the nearest orthopaedic surgeon decreased from 19.2 miles to 8.4 miles.
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Study: Oblique anterolateral approach may offer access to the lumbar spine with few early complications.
According to a study published online in the journal Clinical Orthopaedics and Related Research, an oblique anterolateral approach may offer access to the lumbar spine with few early complications. The authors conducted a chart review of 812 patients who underwent minimally invasive anterior lumbar interbody fusion through a lateral psoas-sparing approach from L1 to L5, and found that 3.7 percent (n = 30) experienced a complication intraoperatively or during the hospital stay. The percentage of vascular complications was 0.37 percent (n = 3) and the percentage of neurologic complications was 0.37 percent (n = 3). “The risk of vascular complications after oblique lumbar interbody fusion seems to be lower compared with reported risk for anterior midline approaches,” the authors write, “and the risk of neurologic complications after oblique lumbar interbody fusion seems to be lower than what has been reported with the extreme lateral transpsoas approach; however, we caution readers that head-to-head studies will need to be performed to confirm our very preliminary comparisons and results with the oblique psoas-sparing approach.”
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Study: Is rhBMP-2 linked to increased risk of complication following scaphoid nonunion revision surgery?
Data from a small study published in the May issue of The Journal of Hand Surgery examines complications associated with the use of recombinant human bone morphogenetic protein (rhBMP-2) in revision scaphoid nonunion surgery. The research team retrospectively reviewed six cases of scaphoid nonunion revision surgery comprising open reduction and internal fixation (ORIF). All patients were treated with revision screw fixation, bone graft, and rhBMP-2, with union determined by computed tomography. The research team found that four patients developed notable heterotopic ossification, one of which required revision surgery. In addition, one patient had a loss of functional motion following revision surgery. Only one of the 6 patients healed without complications. “In this case series, the use of rhBMP-2 in scaphoid nonunions was associated with a higher complication rate than reported in previous studies,” the research team writes. “Surgeons performing off-label use of rhBMP-2 should be aware of the potential for complications including heterotopic ossification.”
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JAAOS introduces open access option.
The AAOS and its publishing partner Wolters Kluwer Health have announced that the Journal of the American Academy of Orthopaedic Surgeons (JAAOS) will begin offering an open access publishing option for authors of manuscripts accepted for publication. Authors of manuscripts who opt for the open access choice retain copyright to their work. AAOS will make the work freely available online to anyone wishing to access it. “Open access is a logical extension of the Journal’s editorial operations and furthers its educational mission,” said AAOS President Gerald R. Williams Jr, MD.
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Call for volunteers: AMA House of Delegates.
AAOS seeks one delegate representative to join the American Medical Association (AMA) House of Delegates. Members of the AMA House of Delegates serve as an important communications, policy, and membership link between the AMA and grassroots physicians. The delegate is a key source of information on activities, programs, and policies of the AMA. The delegate is also a direct contact for the individual member to communicate with and contribute to formulation of AMA policy positions, identification of situations that might be addressed through policy implementation efforts, and implementation of AMA policies. 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, applicants must be AMA members and practicing orthopaedic surgeons.
Learn more and submit your application…(member login required)