Today’s Top Story
1. Study: Hip arthroscopy may be more effective than rehabilitation for many patients with acetabular labral tears.
Data from a study published online in The American Journal of Sports Medicine suggest that, for appropriate patients, hip arthroscopy may be more cost-effective and associated with improved outcomes compared to structured rehabilitation alone for patients with acetabular labral tears. The authors used a Markov decision model and cost estimates from national averages of Medicare reimbursements for a cohort representative of patients undergoing hip arthroscopic surgery at a single center. Compared to rehabilitation alone, they estimated that arthroscopy cost an additional $2,653 in 2014 dollars, but was associated with an additional 3.94 quality-adjusted life-years (QALYs) over a patient’s lifetime. Overall, arthroscopic surgery was cost-effective for 94.5 percent of patients. In addition, although arthroscopic surgery decreased in cost-effectiveness with increasing age, it remained more cost-effective than rehabilitation for patients in the second to seventh decades of life. The lifetime incidence of symptomatic hip osteoarthritis was more than twice as high for patients treated with rehabilitation compared with arthroscopic surgery.
Read the abstract…
Other News
2. ACEP files suit against HHS over ACA rule interpretation.
The American College of Emergency Physicians (ACEP) has filed a lawsuit against the U.S. Department of Health and Human Services (HHS), arguing that the agency’s interpretation of a provision of the Affordable Care Act (ACA) gives private insurers latitude to determine out-of-network rates based on their proprietary databases of historical charges, forcing providers to choose between billing out-of-network patients for the balance of unreimbursed charges or being driven out of business. As reported in Modern Healthcare, the ACA bars insurers from charging patients higher coinsurance and copayments for out-of-network emergency care, but does not prohibit balance billing or require insurers to cover such bills. Under the HHS interpretation, out-of-network providers should be paid whatever amount is the greatest of three options: the Medicare rate; the median in-network rate; or the usual, customary and reasonable charge (UCR). ACEP states that HHS has dismissed repeated pleas for an objective standard for UCR charges, offering insurers too much room to “game the numbers.”
Read more…(registration may be required)
Study: Obese patients at elevated risk for VTE following posterior cervical fusion surgery, but mortality and morbidity otherwise not significantly increased.
Investigators who published a study online in the journal Spine find that posterior cervical fusion surgery may be safe for obese patients. The research team reviewed data from the American College of Surgeons National Surgical Quality Improvement Program database regarding morbidity and mortality, and found a significantly higher rate of only venous thromboembolism (VTE) among obese patients (body mass index >30) compared to non-obese patients. On multivariate analysis, obesity was an independent predictor for VTE. The research team writes that, although obesity predisposed patients to an elevated risk of VTE, post-operative mortality and morbidity were otherwise not significantly increased in the obese cohort.
Read the abstract…
Manufacturer responds to questions about rhBMP-2.
In separate letters to two U.S. Senators, a spokesperson for Medtronic has responded to concerns regarding trials of the company’s recombinant human bone morphogenetic protein-2 (rhBMP-2) product Infuse. The manufacturer previously admitted that it did not report more than 1,000 adverse events to the U.S. Food and Drug Administration within the required 30-day time frame. “While we regret that events from the retrospective chart review were not reported earlier,” the letters state, “we have no information to suggest the failure to report was intentional.” In response to a question about “alarmingly high” injury rates associated with use of the product, the company states, “First, adverse events were reported in accordance with a very conservative approach that captured many events considered by the surgeons to be not related [emphasis theirs] to the use of Infuse. Second, because the survey was a retrospective review and did not have a control group, the number of reported events cannot be directly compared to the number of events that would have occurred in this population absent the use of Infuse.” The company also notes that in an “overwhelming majority of procedures reflected in the charts included in the retrospective review, physicians had elected to use the product in off-label indications.”
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Read the letter to Sen. Al Franken (PDF)…
Read the letter to Sen. Amy Klobuchar (PDF)…
July 1, 2016, is the last day to apply for hardship exemption under CMS EHR incentive program.
The California Medical Association is reminding physicians that July 1, 2016, is the extended deadline for healthcare providers to apply for hardship exemptions under its electronic health records (EHR) incentive payment program. The U.S. Centers for Medicare & Medicaid Services (CMS) has streamlined its hardship exception application forms in order to reduce the level of information required to apply for an exception.
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Learn more from CMS about applying for a hardship exemption…
Learn more from AAOS about applying for a hardship exemption…
Last call for paper, poster, and scientific exhibit abstracts for 2017 AAOS Annual Meeting!
June 1 is the deadline to submit abstracts for paper presentations, poster presentations, and scientific exhibits to the 2017 AAOS Annual Meeting, to be held March 14-18, 2017, in San Diego. The deadline for Orthopaedic Video Theater submissions is July 15. Please note that, prior to abstract submission, presenters and all coauthors must disclose current financial relationships in the AAOS Disclosure Database Program. Disclosure reported on April 1, 2016 or later is acceptable.
Submit your abstract…
Update your disclosures…
Please complete your 2016 AAOS Orthopaedic Surgeon Census now!
AAOS is asking all members to participate in the AAOS 2016 census of orthopaedic surgeons. The census is taken to ensure that AAOS members are accurately represented in advocacy, funding, and reimbursement efforts. The information also helps AAOS tailor programs, products, and services to address professional needs and interests of its members. All individual responses are kept confidential. Watch your email or postal mail for your census form. In addition, this year, AAOS is holding a census contest, with prizes awarded to the states with the highest per capita level of participation!
Read more…(member login required)
For further information, or if you are not sure if you responded, misplaced your questionnaire, or have questions regarding the census, please contact the AAOS research department with your name, email address, and member ID, at aaosresearch@aaos.org.
