Today’s Top Story
Senate committee chair threatens legislative action if HHS won’t delay finalization of Stage 3 meaningful use.
Morning Consult reports that the chair of the U.S. Senate Health, Education, Labor, and Pensions Committee has threatened legislative action if the Obama administration refuses to delay until 2017 finalization of Stage 3 meaningful-use rules. Among other things, the proposed rule for Stage 3 released by the U.S. Department of Health and Human Services (HHS) requires providers to send electronic summaries for 50 percent of patients they refer to other providers, receive summaries for 40 percent of patients who are referred to them, and reconcile past patient data with current reports for 80 percent of such patients. However, many observers say the technology isn’t widely available to carry out such requirements. Read more…
     AAOS, together with a number of other healthcare organizations, sent letters to HHS Secretary Sylvia Burwell and the U.S. Office of Management and Budget (OMB) asking for a pause in Stage 3 implementation and a reevaluation of the meaningful use program in light of recent changes to Medicare. Read the letter to HHS (PDF)…
Read the letter to OMB (PDF)…

Other News

Medical leaders ask CMS to delay implementation of Comprehensive Care for Joint Replacement payment model.
An article in HealthLeaders Media reports on opposition to the U.S. Centers for Medicare & Medicaid Services (CMS) proposed Comprehensive Care for Joint Replacement payment model. Under the model, payment and quality measures for hip and knee arthroplasty would be bundled at hospitals in 75 randomly selected geographic areas, with most hospitals in those regions required to participate. Hospitals in which the procedure is performed would be accountable for costs associated with the entire episode of care, from the time of surgery through 90 days postoperative. A final rule is expected to be released Nov. 1, with an implementation date of Jan. 1, 2016, but the American Association of Orthopaedic Surgeons (AAOS) states that 2 months is not enough time for hospitals to develop the infrastructure necessary to implement the new system, and has asked CMS for a 1-year delay in implementation. Read more…
     The AAOS submitted comments on the proposed rule prior to the deadline date. Read more…

Study: Increased BMI linked to increased risk of LSS.
According to findings from a study conducted in Sweden and published in the Sept. 15 issue of the journal Spine, compared to those with lower body mass index (BMI), obese and overweight people may be at increased risk of lumbar spinal stenosis (LSS). The authors conducted a prospective, cohort study of 364,467 individuals participating in a nationwide occupational surveillance program for construction workers. At baseline, 65 percent of participants had normal weight (BMI 18.5–24.99 kg/m2), 29 percent were overweight (BMI: 25–29.99 kg/m2), 5 percent were obese (BMI =30 kg/m2), and 2 percent were underweight (BMI <18.5 kg/m>2). At mean 31-year follow-up, 2,381 participants were diagnosed with LSS. Compared with normal weight individuals, obese workers had an incidence rate ratio (IRR) of 2.18 for LSS, overweight workers had an IRR of 1.68, and underweight workers had an IRR of 0.52. Read the abstract…

Study: What features are recurrent in tibial plateau fractures?
A study published in the Sept. 16 issue of The Journal of Bone & Joint Surgery attempts to identify recurrent features of tibial plateau fractures. The research team conducted a retrospective study of 127 tibial plateau fractures. They found that 64 of the fractures were Schatzker type I, II, or III; 15 were Schatzker type IV; and 48 were Schatzker type V or VI. Based on computed tomography mapping of the fracture patterns, they found four recurrent fracture features: a lateral split fragment, found in 75 percent; a posteromedial fragment, found in 43 percent; tibial tubercle fragment, found in 16 percent; and a zone of comminution that included the tibial spine and frequently extended to the lateral condyle, found in 28 percent. The researchers state that an understanding of recurrent features of tibial plateau fractures may aid surgeons during diagnosis, preoperative planning, and execution of surgical strategies. Read the abstract…

Study: Patient characteristics linked to hospital readmission rates.
Data from a study published online in the journal JAMA Internal Medicine suggest that hospital readmission rates linked to penalties under Medicare may be significantly affected by patient population factors. The researchers drew survey data on 8,067 patient admissions from the nationally representative Health and Retirement Study (HRS) and linked Medicare claims for HRS participants enrolled in Medicare who were hospitalized between 2009 and 2012. They assessed 29 patient characteristics as potential predictors of 30-day readmission when added to standard Medicare adjustments of hospital readmission rates. The researchers found that 22 of the characteristics significantly predicted readmission beyond standard adjustments, and of those, 17 were distributed differently between hospitals in the highest and lowest quintiles of publicly reported hospital-wide readmission rates. The researchers state that the study data suggest that Medicare may penalize hospitals “to a large extent based on the patients they serve.” Read the abstract…

ONC unveils website to address issues with EHR systems.
Health Data Management reports that the U.S. Office of the National Coordinator for Health Information Technology (ONC) has implemented a new website at which physicians and other stakeholders can file complaints regarding electronic health records (EHR) systems. ONC states that concerns about EHRs, patient portals, and other certified products should start with the vendor, and if an issue remains unresolved, individuals should contact an ONC-Authorized Certification Body for assistance working with the vendor. Finally, if no resolution is found, stakeholders should file a complaint on the ONC complaint website. In particular, ONC wants to know if a problem results due to one or more of the following issues:

  • Intentional blocking of or unreasonable interference with the exchange of health information
  • Being otherwise unable to share or receive health information
  • Usability issues that prevent the EHR from appropriately supporting the work at hand, various workflows, and the needs of users
  • Certified capabilities in the EHR that do not perform appropriately

Read more…
Visit the ONC website…

AAOS, POSNA, and AOSSM to host “Twitter Party” discussion on youth sports safety.
AAOS, the Pediatric Orthopaedic Society of North America (POSNA), and the American Orthopaedic Society of Sports Medicine (AOSSM) will host a Twitter discussion on the issue of sports safety in school-age children on Tuesday, Sept. 22, from 9 p.m. to 10 p.m. ET. The so-called “Twitter Party” will feature the participation of David Geier, MD, and Philip Wilson, MD, who will answer questions from parents, teachers, coaches, and other stakeholders on topics such as teaching sports safety, identifying common sports injuries, and promoting nutrition and hydration in young athletes. Members and their patients are encouraged to log in to Twitter and follow the conversation using hashtag #SafeSports. Read more…

Last call: Spine section editor for OrthoInfo.org.
Sept. 25 is the last day to submit your application for Section Editor—Spine for the AAOS OrthoInfo.org website. OrthoInfo is a patient-targeted website featuring approximately 500 articles, with approximately 35 articles on the topic of spine. Section editors are engaged by AAOS as independent contractors on an annual basis and subject to renewal. Applicants for this position must be active or emeritus fellows with a practice emphasis in spine. In addition, all applicants must provide the following: an online AAOS CAP application, a current curriculum vitae, a letter of interest highlighting the applicant’s expertise in the subject area, and two references. Learn more and submit your application…(member login required)