Today’s Top Story
Medicare bill could increase ACO flexibility, expand initiatives to make Medicare more efficient.
The Hill reports that a bipartisan group of senators has drafted legislation designed to improve efficiency and save money under the Medicare system. If enacted, the Chronic Care Act would among other things increase flexibility for accountable care organizations (ACOs), support increased use of telemedicine, expand a home visit pilot program, and increase funding for a Center for Medicare and Medicaid Innovation program created to fight increases in drug prices.
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Other News
Study: Blood test may help identify early-stage OA.
Findings from a study conducted in the United Kingdom and published online in the journal Arthritis Research & Therapy indicate certain biomarkers may help identify early-stage osteoarthritis (OA). The researchers recruited 225 participants and analyzed plasma/serum and synovial fluid for oxidized, nitrated, and glycated proteins and amino acids using quantitative liquid chromatography-tandem mass spectrometry. They detected glycated, oxidized, and nitrated proteins and amino acids in the synovial fluid and plasma of arthritic patients with characteristic patterns found in early and advanced OA and rheumatoid arthritis (RA), and non-RA, with respect to healthy controls. They developed two algorithms for consecutive use in diagnosis, and found that sensitivities/specificities were: good skeletal health, 0.92/0.91; early-stage OA, 0.92/0.90; early-stage RA, 0.80/0.78; and non-RA, 0.70/0.65. They noted that damaged amino acids increased further in participants with severe and advanced OA and RA.
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Study: How are pathogens transmitted between patients, providers, and rooms?
A study presented at the IDWeek conference examines hospital rooms and healthcare personnel as vectors for pathogen transmission. The research team collected 2,185 cultures from the clothing of 40 intensive care nurses, 455 cultures from 167 patients, and 2,919 cultures from patients’ rooms over 120 12-hour shifts. They confirmed 12 instances of at least one of five pathogens being transmitted from the patient or the room to the scrubs, with six incidents each of transmission from patient to nurse or room to nurse. The research team found an additional 10 transmissions from the patient to the room. They did not document any nurse-to-patient or nurse-to-room transmission. They note that pockets and sleeves of scrubs were most likely to be contaminated, as were the bed rails in the rooms.
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California.
According to HealthLeaders Media, the governor of California has signed legislation to allow certain critical access hospitals to directly employ physicians. The new law applies to facilities with 25 or fewer beds and implements a pilot program that will take effect Jan. 1, 2017 and sunset after 8 years. Hospitals in California are generally banned from direct employment of physicians under a corporate medicine law designed to prevent hospital administrators from influencing physician decisions.
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Florida.
Health News Florida reports that an appeals court in the state has ruled that caps on noneconomic damages in medical liability suits are unconstitutional. The state enacted caps in 2003, but in 2014, the Florida Supreme Court determined that such caps were unconstitutional in a wrongful-death case involving a woman who died after giving birth in a hospital. The state Supreme Court is currently considering a third case that could determine the constitutionality of noneconomic damage caps in medical liability lawsuits.
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ADA joins AAOS in approving AUC on Management of Patients with Orthopaedic Implants Undergoing Dental Procedures.
The American Dental Association (ADA) has approved the AAOS Appropriate Use Criteria (AUC) addressing the administration of antibiotics prior to dental procedures in patients with joint replacement implants. The AUC, developed jointly with ADA, advise that most patients with replacement hip, knee, shoulder, or other implants are not at risk for periprosthetic infection following dental procedures. However, the guidelines recommend consideration of antibiotic administration for patients with severely compromised immune systems due to AIDS, uncontrolled diabetes, or recent history of joint infection; for patients taking certain medications for rheumatoid arthritis; or to prevent complications linked with organ transplant.
The AUC, available through the AAOS OrthoGuidelines website and app, include questions for clinicians to gauge risk related to the type of dental procedure, given the patient’s implant status and overall health. Each of the 64 scenarios has an antibiotic “appropriateness rating” from 1 to 9, which was determined by a 14-member voting panel of orthopaedic surgeons, dentists, oral surgeons, and epidemiologists.
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