Today’s Top Story
Senate Republicans signal more measured approach to ACA changes.
As the Senate heads home for an extended holiday recess, Republicans in the upper chamber don’t yet have a final plan mapped out for overhauling the Affordable Care Act (ACA). After the Congressional Budget Office declared Wednesday that a House-passed plan would result in 23 million people losing coverage, Senate Republicans began maneuvering to take a more modest tack. Bloomberg reported that senators are mulling a two-step approach that would delay a repeal of “Obamacare” until 2020 and would slow the phase-out of Medicaid expansion called for in the House bill. Third-ranking Republican John Thune of South Dakota said a Senate plan would likely continue subsidies for co-pays and deductibles. Meanwhile, The Hill reported that the trade group for insurance companies wrote to Senate Republicans in support of retaining ACA provisions that prevent denial of coverage to persons with preexisting conditions—which the House bill would effectively allow. Read more from Bloomberg
Read an analysis in The Atlanta Journal-Constitution
Read about insurers’ position in The Hill…

Other News

Study: CNFC may reduce opioid use for geriatric patients with proximal femur fracture.
According to a study published in the June issue of the Journal of Orthopaedic Trauma, use of continuous femoral nerve catheter (CNFC) for postoperative pain control may be associated with reduced opioid consumption for older patients with proximal femur fracture. The researchers conducted a retrospective, comparative study of 265 consecutive geriatric hip fracture patients who underwent surgical treatment, 149 of whom were treated with standard analgesia without nerve catheter and 116 of whom received an indwelling CFNC. They found that patients in the CFNC cohort reported lower average pain scores preoperatively, on postoperative day 1, and on postoperative day 2. In addition, the CFNC group consumed 39 percent less morphine equivalents on postoperative day 1 and 50 percent less morphine equivalents on postoperative day 2. Compared with patients undergoing standard analgesia, patients with CFNC had a lower rate of opioid-related side effects and were more likely to be discharged to home. Read the abstract…

Study: Patients and clinicians often have different views on error disclosure.
Findings from a study published online in the Journal of Patient Safety highlight differences in viewpoints between clinicians and patients regarding disclosure of medical errors. The researchers surveyed 50 clinicians and 65 patients and family members from a hospital patient and family advisory council. They found that patients’ and family members’ views about disclosure were significantly different from clinicians’ in 70 percent of disclosure expectation items and 100 percent of disclosure vignette items. Compared with clinicians, patients and family members more strongly agreed that “patients want to know all the details of what happened” and more strongly disagreed that “patients find explanation(s) more confusing than helpful.” In the medication error vignette, compared to clinicians, patients and family members more strongly agreed that the error should be disclosed and that the patient would want to know, and more strongly disagreed that disclosure would do more harm than good. The researchers write that after completing a workshop on medical error disclosure, both groups’ viewpoints on information sharing, fallibility, truth telling, and threshold for disclosure displayed greater concordance. Read the abstract…

California.
The California Medical Association (CMA) reports that the California Department of Public Health has developed an opioid prescriber resource guide designed to help physicians manage their patients’ pain while avoiding opioid misuse and addiction. The guide includes the following resources:

  • strategies for assisting high-risk patients
  • information on medication-assisted treatment certification programs
  • assistance regarding how to locate local addiction recovery services
  • information about CURES (California’s prescription drug monitoring program)
  • guidelines on prescribing opioids

The CMA provides additional resources on the safe and effective prescribing of controlled substances on its website. Read more…
View the guide…
CMA resources…

Call for volunteers: Voting panel for pediatric developmental dysplasia of the hip AUC.
The Appropriate Use Criteria (AUC) Section seeks AAOS fellows to participate on the voting panel for the Detection and Nonoperative Management of Pediatric Developmental Dysplasia of the Hip (DDH) in Infants Up to Six Months of Age AUC. The voting panel will participate in two rounds of voting, during which it will rate the appropriateness of various treatments for pediatric patients who are at risk of DDH. Voting panel members will be required to attend a 1-day, in-person meeting in Rosemont, Ill. Nominees for the voting panel are required to complete the AAOS conflict of interest enhanced disclosure form online. If you are interested in participating on the voting panel for this AUC topic, please contact Mary DeMars by Friday, June 30, 2017, at: demars@aaos.org (email)

Nominate a colleague for the AAOS Diversity, Humanitarian, or Tipton Leadership Award!
Friday, June 9, 2017, is the last day to submit nominations for the 2018 Diversity and Humanitarian Awards and the William W. Tipton Jr, MD, Orthopaedic Leadership Award. These awards are presented annually at the AAOS Annual Meeting. The respective award recipients are recognized for their endeavors to further encourage diversity or culturally competent care, participation in humanitarian activities, or leadership activities in the orthopaedic profession. Read more…

June AAOS Now is online now and in your mailbox soon!
AAOS members will soon receive the print edition of the June issue of AAOS Now, but the online edition is already available on the AAOS Now website. This month’s issue includes an article on Research Capitol Hill Days, highlights from the Urban Legends of TKA Instructional Course Lecture at the AAOS Annual Meeting, profiles of orthopaedic humanitarians, and much more! Read more…(member login required)
Read “Fighting for Funding”…
Read “Evidence-based Medicine Meets Urban Legends of TKA”…
Read “Profiles in Compassion: Orthopaedic Humanitarians”…