November 10, 2017 |Today’s News

Report suggests that 29 percent of healthcare payments were tied to APMs in 2016

A report from the not-for-profit organization Health Care Payment Learning & Action Network (LAN) finds that 29 percent of total U.S. healthcare payments were tied to alternative payment models (APMs) in 2016, compared to 23 percent in 2015. The organization reviewed data from four sources: the LAN, America’s Health Insurance Plans, the Blue Cross Blue Shield Association, and the U.S. Centers for Medicare & Medicaid Services (CMS) The writers of the report say that the findings suggest that progress is on pace to meet goals to tie 30 percent of total U.S. healthcare payments to APMs by 2016 and 50 percent by 2018.

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Study: Blood cobalt and chromium levels may not be linked to cardiotoxicity for patients with MOM hip implants

A study published in the Nov. 1 issue of The Journal of Bone & Joint Surgery suggests that high (but not extreme) blood cobalt and chromium levels may not be associated with a significant cardiotoxic effect on patients with a metal-on-metal (MOM) hip implant. The research team conducted a prospective, blinded study of 90 patients assigned to three age- and sex-matched cohorts: ceramic-on-ceramic, MOM with low whole-blood metal ion levels, and MOM with high whole-blood metal ion levels. Members of the research team noted that blood cobalt levels differed significantly across cohorts. However, they found no significant differences across cohorts in left atrial or ventricle size, ejection fraction, T1 or T2 values, extracellular volume, B-type natriuretic peptide level, or troponin level, and all values were within normal ranges. In addition, they observed no relationship between cobalt levels and ejection fraction, even at extremes, suggesting no clinically important association.

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Data presented at the annual meeting of the American College of Rheumatology suggest racial disparity in outcomes for total hip arthroplasty (THA) patients. The researchers reviewed data on 4,170 patients from an institutional THA registry and found that, at baseline and 2-year follow-up, black patients had worse Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function scores compared to white patients. They note that disparities were increased in communities with a high percentage of Medicaid patients; among black patients in such communities, 2-year WOMAC function scores were on average 5.54 points lower than among black patients from communities with a low prevalence of Medicaid coverage. Scores for white patients did not differ significantly between communities.

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In a letter to CMS administrator Seema Verma, two senators have asked for a timeline regarding the inclusion of unique device identifiers (UDIs) on Medicare claim forms. The legislators note that a recent report from the U.S. Department of Health & Human Services Office of Inspector General recommended that UDIs be included on the next version of claim forms, as Medicare claims data does not currently support the identification and tracking of recalled or prematurely failed medical devices. The senators have asked Ms. Verma to clarify by Dec. 1, 2017, if the agency supports inclusion of UDIs on Medicare claims, and if the policy is still under review, to explain what issues are under review and a timeline for completion of the review.

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The American Association of Orthopaedic Surgeons (AAOS) supports the inclusion of UDIs on Medicare claim forms.

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Survey data published online in the Journal of the American College of Surgeons suggests that many surgical residents experience high levels of burnout, severe stress, and distress symptoms. The authors surveyed 566 residents from Accreditation Council for Graduate Medical Education-accredited general surgery programs. They found that 69 percent of respondents reported burnout and higher burnout was associated with high stress, depression, and suicidal ideation. Overall, perceived stress and distress symptoms were high across training levels but improved during lab years. The authors note that dispositional mindfulness was associated with lower risk of burnout, stress, anxiety, suicidal ideation, and depression, supporting the potential for mindfulness training to promote resilience during surgery residency.

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The American College of Physicians (ACP) recently released a position paper on improving patient safety in the outpatient setting. Among other things, the organization outlines a series of principles, including:

• Healthcare providers have a responsibility to promote a culture of patient safety within their practices and among colleagues
• Healthcare stakeholders should conduct research to address physician stress, burnout, and organizational culture that may impact medical errors
• Health literacy efforts should educate the public regarding the right questions to ask and necessary information to supply to providers
• Team-based care models, such as the patient-centered medical home, should be encouraged

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Call for abstracts: AAOS biologics research symposium

AAOS is sponsoring 15 young investigators to attend and present their research at the upcoming AAOS Optimizing Clinical Use of Biologics in Orthopaedic Surgery Research Symposium, to be held Feb. 15-17, 2018, in Stanford, Calif. In addition, selected young investigators will present a poster during a dedicated poster session. AAOS is seeking abstracts in the area of biologics, including platelet rich plasma, minimally manipulated adult progenitor cells, tendinopathy, or tissue repair. Selected young investigators will receive airfare, lodging, and meals at the event. The application deadline is Dec. 1, 2017.

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