Today’s Top Story
Study: Implant-specific blood metal ion thresholds may improve identification of MOM patients at risk of ARMD.
A study conducted in Europe and published in the Sept. 20, 2017, issue of The Journal of Bone & Joint Surgery suggests that implant-specific blood metal ion thresholds may be more effective in identifying metal-on-metal (MOM) hip arthroplasty patients who may be at risk of adverse reactions to metal debris (ARMD). The authors performed a validation study of 710 patients (803 MOM arthroplasties), divided into two cohorts: those with ARMD (n = 75) and those without (n = 635). They found that predictive values for implant-specific thresholds to distinguish between patients with and without ARMD ranged from 89.4 percent to 97.1 percent. Overall, implant-specific thresholds missed 20 patients with ARMD (2.8 percent), compared to 21 (3.0 percent) based on a fixed threshold of 3 µg/L for both cobalt and chromium, and 46 (6.5 percent) based on a fixed threshold of 10 µg/L for both cobalt and chromium. Read more…
Read the abstract…

Other News

Study: SST may be a valid and responsive outcome measure after shoulder arthroplasty.
Data published in the October issue of the Journal of Shoulder and Elbow Surgery suggest that the Simple Shoulder Test (SST) may be a valid and responsive patient-reported outcome measure for assessing the outcomes of shoulder arthroplasty. The authors analyzed information on 408 shoulder arthroplasties, including SST scores, 36-Item Short Form Health Survey scores, and satisfaction scores, collected preoperatively and 2 years postoperatively. They found that change in SST strongly correlated with patient satisfaction, with validity supported by significant differences between satisfied and unsatisfied patients, those with more severe and less severe comorbidities, those with workers’ compensation or Medicaid and other types of insurance, those with and without previous failed shoulder surgery, and those taking and those not taking opioid pain medication prior to surgery. Read the abstract…

National Academy of Medicine releases opioid guide for clinicians.
The National Academy of Medicine has released a new guide to help health clinicians address the opioid epidemic. The guide states that, with the exception of “conditions such as cancer, palliative care, and end-of-life, clinicians should first look to nonopioid approaches that are effective for chronic pain control.” And if realistic benefits outweigh the risk of opioids for a given patient, “clinicians should use them in combination with other modalities, as appropriate, to provide greater benefits to patients in improving pain and function.” The guide also identifies clinician leverage points that can be used to counter the opioid epidemic, including:

  • Using a team approach to care.
  • Precautionary prescribing that accounts for individual risk factors and social circumstances.
  • Counseling on secure storage and proper disposal of unused opioids.
  • Cross-checking the Prescription Drug Monitoring Program registry.
  • Providing referrals for treatment assistance, as indicated, including follow-up with the referral team.
  • Engaging with the community to promote the availability of necessary substance use disorder treatment resources.

Read more…
Download the guide…

CMS updates info on MIPS participation.
The U.S. Centers for Medicare & Medicaid Services (CMS) has updated its resources for participation in the Merit-based Incentive Payment System (MIPS). For 2017, to fully participate in the Quality performance category, providers must report on one or the other of the following:

  • Six quality measures, one of which is required to be an outcome measure, or if not available, a high-priority measure.
  • A complete specialty measure set. All of the measures in a specialty set will be assessed when less than 50 percent of possible data are submitted.

If a provider submits data on fewer than six quality measures, CMS will conduct an eligible measure applicability (EMA) process to identify clinically related measures that could have been submitted. The EMA process:

  • Uses a clinical relations test to see if a provider could have submitted more measures.
  • Adjusts the scoring to accurately reflect how the clinical relations test affected provider performance.

Providers with questions about EMA may contact the Quality Payment Program at 866-288-8292 or 877-715-6222 (TTY) Monday through Friday, 8 a.m – 8 p.m. ET, or via email at:
Download EMA information materials (ZIP)…

CMS updates information for providers affected by recent hurricanes.
CMS has posted to its website information for providers affected by hurricanes Harvey, Irma, and Maria. The agency states that it will “exercise allowable flexibilities and issue waivers as needed to accommodate the needs of those impacted by an emergency or disaster.” In addition, CMS can issue blanket waivers to prevent gaps in access to care for beneficiaries impacted by an emergency. The agency notes that providers do not need to apply for an individual waiver if a blanket waiver has been issued, or if no blanket waiver has been issued, providers can request an individual waiver. Read more…

AAOS Board approves CMS osteoarthritis performance measure.
The AAOS Board of Directors has approved the 2017 Osteoarthritis Function and Pain (OAFP) Assessment Measure. The measure was reviewed, updated, and validated by the OAFP workgroup, with oversight from the Performance Measure Committee. This MIPS quality measure is available as CMS Performance Measure #109. Read more…
View the measure specifications (PDF)…

Call for volunteers: NQF MAP Medicaid Adult and Child Workgroups.
AAOS seeks to nominate members to the National Quality Forum (NQF) Measure Applications Partnership (MAP) Medicaid Adult and Child Workgroups. NQF will convene two multi-stakeholder workgroups to provide guidance to the U.S. Department of Health & Human Services on metrics to improve healthcare quality for the nation’s Medicaid population. Applicants for these positions 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 (maximum 20 pages), a 100-word biography, and a letter of interest highlighting his or her expertise in the subject area. All supporting materials must be submitted to Kyle Trivedi by Oct. 8, 2017, at 11:59 p.m. CT, at:
Learn more and submit your application…(member login required)