Today’s Top Story

CBO: Tax proposal could force cut to Medicare funding

The U.S. Congressional Budget Office (CBO) states that a tax reform proposal currently under consideration in the U.S. Congress could result in a mandatory cut of up to $25 billion in Medicare funding during 2018. The Statutory Pay-As-You-Go Act of 2010 (PAYGO) requires that new congressional legislation not collectively increase estimated deficits. If a net increase in the deficit occurs, the U.S. Office of Management and Budget is required to order a sequestration to eliminate the overage. According to CBO, a deficit of $136 billion next year would force sequestration cuts across several programs with mandatory funding, including Medicare. The agency notes that the PAYGO law limits reductions to Medicare funding under sequestration to 4 percentage points, or about $25 billion. CBO projects that maximum cuts across all mandatory programs would not fully compensate for the expected deficit, resulting in a maximum funding reduction for Medicare.

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Read the CBO comment letter (PDF)…

Other News

Study: What factors increase risk of arthrodesis or amputation for patients with failed TKA?

A study published in the December issue of the journal Clinical Orthopaedics and Related Research examines trends associated with failure of total knee arthroplasty (TKA). The researchers reviewed information on 44,466 patients aged 65 years or older from the Medicare 100% National Inpatient Claims Database, all of whom were diagnosed with infected TKA and underwent revision. The researchers identified 1,182 knee arthrodeses and 1,864 above-knee amputations (AKAs) among the study population. They note that clinical factors associated with arthrodesis included acute renal failure, obesity, and having additional infection-related revisions, while higher Charlson comorbidity score, obesity, deep vein thrombosis, and additional revisions were factors associated with increased likelihood of AKA. The researchers found that increased risk of mortality was linked with amputation but not arthrodesis.

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Study: Nail and locking plate fixation offer similar outcomes for adults with acute, displaced, extra-articular fracture of the distal tibia

Data from a study published in the Nov. 14 issue of The Journal of the American Medical Association suggest similar outcomes for nail fixation or locking plate fixation of acute, displaced, extra-articular fracture of the distal tibia in adult patients. The authors conducted a multicenter, randomized trial of 258 patients aged 16 years or older who underwent fixation with either intramedullary nail or locking plate They found a statistically significant difference in favor of nail fixation based on Disability Rating Index (DRI) at 3-month follow-up, but no such difference at 6 or 12 months. The authors also found no statistically significant difference in complication across cohorts, including number of postoperative infections. However, they note that further surgery was more common in the plate group at 12-month follow-up.

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HHS releases progress report on resistant bacteria efforts

The U.S. Department of Health and Human Services (HHS) has released a progress report on the National Action Plan for Combatting Antibiotic-Resistant Bacteria. The report outlines progress made on the following five areas of the National Action Plan for Combating Antibiotic Resistant Bacteria:

1.    Slow the emergence of resistant bacteria and prevent the spread of resistant infections

2.    Strengthen national one-health surveillance efforts to combat resistance

3.    Advance development and use of rapid and innovative diagnostic tests for identification and characterization of resistant bacteria

4.    Accelerate basic and applied research and development for new antibiotics, other therapeutics, and vaccines

5.    Improve international collaboration and capacities for antibiotic-resistance prevention, surveillance, control and antibiotic research and development

The report notes that methicillin-resistant Staphylococcus aureus in U.S. acute care hospitals declined 13 percent between 2011 and 2014, and an additional 5 percent by 2016, and Clostridium difficile infection declined in U.S. acute care hospitals 8 percent between 2011 and 2014, and a further 7 percent by 2016. However, as of 2014, only 39 percent of all U.S. hospitals had antibiotic stewardship programs that followed all seven of the U.S. Centers for Disease Control and Prevention’s Core Elements of Hospital Antibiotic Stewardship.

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Read the report (PDF)…

Clinicians have until Dec. 31 to make changes to their Medicare participation status

The California Medical Association is reminding physicians that they have until Dec. 31, 2017, to update their Medicare participation status for 2018. Clinicians can choose to be a participating provider, a nonparticipating provider, or opt out of Medicare entirely. The organization notes that physicians who opt out of Medicare are bound only by private contracts with patients. However, when a physician enters into a private contract with a Medicare beneficiary, both the physician and patient agree not to bill Medicare for services provided under the contract. As a result of the Medicare Access and CHIP Reauthorization Action of 2015 (MACRA), validated opt-out affidavits signed on or after June 16, 2015, will automatically renew 2 years after the effective date.

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AMA recognizes former AAOS CEO with lifetime achievement award

The American Medical Association (AMA) has recognized former AAOS chief executive officer (CEO) Karen L. Hackett, FACHE, CAE, with the association’s Medical Executive Lifetime Achievement Award. “During her 14-year tenure at AAOS, Karen Hackett has led innovation and change that are positively impacting the lives of Americans everywhere,” said AMA President David O. Barbe, M.D. “Under her leadership, the organization has, among other things, embraced quality initiatives, clinical practice guidelines and performance standards to advance the quality of orthopaedic care for patients.”

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Call for volunteers: HHS Advisory Committee on Minority Health

AAOS seeks to nominate members to the HHS Advisory Committee on Minority Health. The committee provides advice to the Deputy Assistant Secretary for Minority Health on improving the health of racial and ethnic minority groups and on the development of goals and specific program activities designed to improve the health status and outcomes of racial and ethnic minorities. 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, all applicants must provide the following: an online AAOS CAP application, a current curriculum vitae (not exceeding 10 pages), a summary of the nominee’s experience and qualifications, and a letter of interest highlighting his or her expertise in the subject area. All supporting materials must be submitted to Kyle Trivedi by Dec. 14, 2017, at 11:59 p.m. CT, at:

Learn more and submit your application…  (member login required)