Today’s Top Story
House asks federal court to pause suit challenging ACA subsidy program.
Politico reports that the U.S. House of Representatives has asked the Federal Court of Appeals for the D.C. Circuit to temporarily pause a House lawsuit challenging a program implemented through the Affordable Care Act (ACA) and designed to help lower-income people pay deductibles, co-payments, and other out-of-pocket expenses under the ACA. The House argues, and a judge previously ruled, that Congress never provided explicit authority for the spending. The judge blocked further spending under the program, but suspended the order pending appeal. If the U.S. Department of Justice under President-elect Donald Trump drops the appeal, health insurance companies would legally be allowed to drop their ACA health plans, potentially destabilizing the ACA exchange market and effectively eliminating a fundamental portion of the healthcare law. However, even some staunch opponents of the ACA argue for caution in proceeding with that scenario, as millions of people could effectively lose their health insurance with little notice. Read more…

Other News

Study: What factors are associated with transition to surgery for patients with meniscal tear and knee OA?
A study published in the Nov. 16 issue of The Journal of Bone & Joint Surgery examines predictors for crossover to surgery from physical therapy (PT) for patients with meniscal tear and knee osteoarthritis (OA). The authors conducted a randomized trial of 341 patients aged 45 years or older with mild-to-moderate OA and a degenerative meniscal tear, who were treated with either arthroscopic partial meniscectomy (APM) with PT (n = 164) or PT only (n = 177). The authors found that 48 PT-only patients (27 percent) crossed over to undergo APM within 140 days following randomization. Factors associated with a higher likelihood of crossing over to APM included a baseline Western Ontario and McMaster Universities Osteoarthritis Index Pain Score of ≥40 and symptom duration of ≤1 year. The authors note that 81 percent of patients who crossed over to APM and 82 percent of patients randomized to APM had an improvement of ≥10 points in their pain scores at 6 months, compared to 73 percent of those who received PT only. The authors write that patients “who crossed over had rates of surgical success similar to those of the patients who had been randomized to surgery,” suggesting that “an initial course of rigorous PT prior to APM may not compromise surgical outcome.” Read the abstract…

Studies suggest links between medications and hip fracture risk.
Two recent studies examine relationships between medication and risk of hip fracture. The first, published online in the journal JAMA Internal Medicine, suggests that use of thiazide diuretics for treatment of hypertension may be associated with reduced risk of hip and pelvic fracture. The researchers followed 22,180 participants in the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial for up to 8 years, 16,622 of whom had claims data available for up to 5 additional years. After adjustment, they found that participants who were randomized to receive chlorthalidone vs. amlodipine or lisinopril had a lower risk of fracture. Overall, risk of fracture was significantly lower in participants randomized to receive chlorthalidone vs. lisinopril, but not significantly different compared with those randomized to receive amlodipine. Through the trial and post-trial period, the cumulative incidence of fractures was nonsignificantly lower in participants randomized to receive chlorthalidone vs. lisinopril or amlodipine, and vs. each medication separately. Read more…
Read the abstract…
     In the second study, conducted in Finland and published online in the Journal of the American Medical Directors Association, the research team performed a retrospective cohort study of 70,718 patients diagnosed with Alzheimer’s disease and a matched cohort, and found an association between prescribing of benzodiazepine and related drugs and increased risk of hip fracture in persons with and without Alzheimer’s disease. Read more…
Read the abstract…

NIH outlines “National Pain Strategy.”
The National Institutes of Health (NIH) has released a National Pain Strategy report. The goal of the report is to initiate further efforts to “create a cultural transformation in how pain is perceived, assessed, and treated.” The report includes suggestions to reduce barriers to pain care and help increase patients’ knowledge of pain treatment options and risks. Key topics covered in the report include:

  • Population research
  • Prevention and care
  • Disparities
  • Service delivery and reimbursement
  • Professional education and training
  • Public education and communication

Read the report (PDF)…
Read more in The Journal of the American Medical Association

CMS releases list of proposed quality and efficiency measures.
The U.S. Centers for Medicare & Medicaid Services (CMS) and U.S. Department of Health & Human Services (HHS) have released the 2016 list of quality and efficiency measures under consideration for adoption. The 97 proposed reporting measures include:

  • Median time to pain management for long bone fracture
  • Average change in back pain following lumbar discectomy and/or laminotomy
  • Average change in back pain following lumbar fusion
  • Average change in leg pain following lumbar discectomy and/or laminotomy
  • Hospital visits following orthopedic ambulatory surgical center procedures
  • Intraoperative timeout safety checklist
  • Patient-centered surgical risk assessment and communication

HHS will accept comment on the measures through Feb. 1, 2017. Read more…
Learn more about the list of measures and the selection process, with related links…

Call For Volunteers: Surgical management of osteoarthrosis of the knee performance measure development workgroup.
AAOS is currently accepting applications for a workgroup that will develop a set of performance measures for surgical management of osteoarthritis of the knee (SMOAK). The Performance Measures Committee seeks an interdisciplinary work group of approximately 18 individuals with the following perspectives and areas of expertise:

  • Subject matter expertise
  • Consumer/patient/family perspective
  • Health care disparities
  • Performance measurement
  • Quality improvement
  • Purchaser perspective
  • Health Informatics

Applicants must have no relevant financial conflicts of interest and be willing to sign an attestation form declaring that they will maintain an absence of relevant conflicts for the duration of the measure development process and 2 full years following. Applications must be submitted by Nov. 30, 2016. For more information regarding the application process, contact Meghan Hough at 847-384-4323 or via email, at:
Access the workgroup application…

Call for volunteers: Instructional Course Committees.
Dec. 21 is the last day to submit your application for a position on an Instructional Course Committee. Members of Instructional Course Committees grade Instructional Course Lecture applications, provide input regarding course curriculum, and evaluate courses at the AAOS Annual Meeting. The following openings are available:

  • Adult Reconstruction Hip (chair, two members)
  • Adult Reconstruction Knee (two members)
  • Hand and Wrist (one member)
  • Pediatrics (two members)
  • Practice Management (one member)
  • Spine (four members)
  • Tumor (two members)

Applicants for these positions must be active fellows with a practice emphasis in the relevant area. Learn more and submit your application…(member login required)

Note: AAOS offices will be closed Nov. 24 and 25 for the Thanksgiving holiday. AAOS Headline News Now will not be published on Friday, Nov. 25. Publication will resume Monday, Nov. 28.