Today’s Top Story
Some commercial insurers slow to support value-based models.
An article in HealthLeaders Media looks at physician efforts to move commercial payers toward value-based payment models. The writer notes that many insurers offer little or no support in funding innovative clinical models required to move away from a fee-for-service payment system. The article profiles one healthcare system’s efforts to collaborate with insurers on value-based models. In at least one instance, the insurer allowed the health system to select the metrics by which physicians will be measured on quality and outcomes, which has helped improve physician buy-in to the transition.
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Other News
Study: Provocative discography may be linked to injury of the lumbar intervertebral disk.
Findings from a study published recently in The Spine Journal suggest that disk puncture and pressurized injection performed during provocative discography may be linked to increased risk of clinical disk problems. The researchers conducted a prospective, matched cohort study of 75 patients without current low back pain who underwent provocative discography at the L3–S1 discs, and 75 matched controls who underwent a similar evaluation except for discography injections. At 10-year follow-up, 57 discography participants and 53 control participants had completed all interval surveillance evaluations. The researchers found that there were 16 lumbar surgeries in the discography group and four in the control group. In addition, medical visits, computed tomography and magnetic resonance imaging examinations, work loss, and prolonged back pain episodes were all more frequent in the discography group compared with controls.
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Study: Physician burnout and satisfaction linked to reductions in full-time employment.
According to a study published in the April issue of the journal Mayo Clinic Proceedings, physician burnout and declining satisfaction may be associated with reductions in professional work effort. The research team reviewed administrative and payroll records to longitudinally evaluate the professional work effort of faculty physicians at a single, large, healthcare organization, from Oct. 1, 2008, to Oct. 1, 2014. Over the term of the study, they found that the proportion of physicians working less than full-time increased from 13.5 percent to 16.0 percent. Compared against physician surveys conducted in 2011 and 2013, the research team found that burnout and satisfaction scores correlated with actual reductions in full-time employment (FTE) over the following 24 months. After adjustment, they found that each 1-point increase in the 7-point emotional exhaustion scale and each 1-point decrease in the 5-point satisfaction score were associated with a greater likelihood of reducing FTE over 24 months.
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Study: Elevated levels of C-reactive protein linked to delirium in older surgical patients.
A study published online in the journal Biological Psychiatry looks at the issue of delirium in older surgical patients. The authors reviewed data on 566 dementia-free patients (age 70 years or older) participating in the Successful Aging after Elective Surgery study. They collected plasma from patients at four time points: preoperative, postanesthesia care unit, postoperative day 2, and 1 month postoperative. They found that C-reactive protein emerged as the strongest delirium-related protein, and a validation test confirmed that, compared with controls, cases had significantly higher C-reactive protein levels in the discovery, replication, and pooled cohorts at all time points, excluding 1 month postoperative.
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Study: Mouse study suggests high-fat diet linked to atherosclerosis and bone loss.
Findings from a study published online in the journal Endocrinology and Metabolism suggest that patients with atherosclerosis may also be at increased risk of osteoporosis. The authors conducted a mouse study and found that osteoblast number and function were dramatically reduced in trabecular and cortical bone of mice fed high-fat diets (HFD), whereas osteoclast number was modestly reduced only in trabecular bone, suggesting that an imbalance in favor of osteoclasts was responsible for HFD-induced bone loss.
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Growing number of states require database consultation prior to opioid prescribing.
An article on Stateline looks at the issue of state-level efforts to reduce so-called “doctor shopping” by requiring physicians to consult prescription databases. In response to a drug epidemic linked to an estimated 28,000 deaths during 2014, 16 states have enacted laws that require prescribers to research patients’ prescription drug histories before prescribing opioid painkillers, sedatives, or other potentially harmful drugs. The U.S. Centers for Disease Control and Prevention and the White House Office of National Drug Control Policy have encouraged other states to do the same.
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AAOS to host webinar on Quality Outcomes Data workgroup recommendations.
The Council on Research and Quality will host a webinar to present the outcomes of the Quality Outcomes Data (QOD) workgroup. In 2015, the QOD workgroup was appointed to investigate partnership opportunities for the collection of quality data and to investigate and evaluate data collection instruments that could be utilized by AAOS members. The 1-hour webinar will offer participants the opportunity to ask questions about the development of the workgroup’s recommendations and future plans. The webinar will take place Monday, May 23, from 7:00 pm to 8:00 pm CT.
Register for the webinar…
