Today’s Top Story
House representatives request flexibility in MACRA implementation to address provider needs.
Bipartisan leaders from two U.S. House of Representatives committees have sent a letter to U.S. Department of Health & Human Services Secretary Sylvia Burwell stressing the importance of a successful implementation of Medicare Access and CHIP Reauthorization Act (MACRA). The letter requests that the U.S. Centers for Medicare & Medicaid Services (CMS) consider flexible rulemaking that addresses the following needs of various healthcare providers:
- Simplified, streamlined, coordinated requirements
- Clear pathways to succeed in Merit-Based Incentive Payment System (MIPS) or the Alternative Payment Model (APM) tracks
- Opportunities to move to the APM track and flexibilities to be rewarded for meaningful delivery system reform activities in MIPS and in the APMs
- Appropriate systems ready and in place prior to January 2017 reporting
“The Congressional intent for MACRA was twofold: to consolidate, streamline, and ease the burden of the various quality reporting programs for physicians and practitioners and to incentivize quality, value-based care through aligned payment bonuses and reductions for physicians and practitioners,” the writers note. “With these principles, we urge [CMS] to ensure that all physicians and practitioners have an equal opportunity to succeed under the Quality Payment Program.” Read more…
Read the letter (PDF)…
Other News
Study: Some physicians spend two-thirds of their time on desk work and EHRs.
Findings from a study published online in the journal Annals of Internal Medicine suggest that some physicians may spend as much as two-thirds of their work time on electronic health records (EHRs) and desk work. The researchers tracked the work habits of 57 physicians, 21 of whom also completed after-hours diaries. They found that during the office day, participants spent 27.0 percent of their total time on direct clinical face time with patients and 49.2 percent of their time on EHR and desk work. While in the examination room with patients, physicians spent 52.9 percent of the time on direct clinical face time and 37.0 percent on EHR and desk work. In addition, physicians who completed after-hours diaries reported 1 to 2 hours of after-hours work each night, devoted predominantly to EHR tasks. The researchers note that the study is descriptive and does not support formal statistical comparisons or projections. Read more…
Read the abstract…
Study: Use of “low-value” services may significantly increase healthcare spending.
A research letter published online in the journal JAMA Internal Medicine suggests that so-called low-value services (as defined by the Choosing Wisely initiative) may drive up healthcare spending in the United States. The research team reviewed claims information from a commercial insurer on 1,468,689 patients, and assessed predictors of disproportionate low-value spending using a two-part model that adjusted for patient and plan characteristics. They found that 114,732 patients (7.8 percent) received low-value services in 2013, accounting for $32.8 million in spending. The most commonly received low-value services included triiodothyronine measurement in hypothyroidism, imaging for nonspecific low back pain (LBP), and imaging for uncomplicated headache. Additionally, the treatments that accounted the greatest proportion of spending were spinal injection for LBP ($12.1 million; 37.0 percent), head imaging for uncomplicated headache ($3.6 million; 11.0 percent), and imaging for nonspecific LBP (3.1 million; 9.4 percent). Read more…
Read the abstract…
Study: How do injuries affect return-to-play in the NFL?
A study published online in The American Journal of Sports Medicine examines the career effect of certain orthopaedic procedures performed on National Football League (NFL) athletes. The researchers conducted a case series study of 559 NFL players who underwent procedures for anterior cruciate ligament (ACL) tear, Achilles tendon tear, patellar tendon tear, cervical disk herniation, lumbar disk herniation, sports hernia, knee articular cartilage repair (microfracture technique), forearm fracture, tibial shaft fracture, or ankle fracture. They found that 79.4 percent of athletes returned to play following the procedure. The researchers note that forearm open reduction and internal fixation (ORIF), sports hernia repair, and tibia intramedullary nailing (IMN) were associated with significantly higher return-to-play rates, compared to patellar tendon repair. Overall, athletes who underwent ACL reconstruction, Achilles tendon repair, patellar tendon repair, and ankle fracture ORIF displayed significant declines in games played at 1 year, but recovered to baseline at 2 to 3 years following surgery. Athletes undergoing ACL reconstruction, Achilles tendon repair, patellar tendon repair, and tibia IMN displayed decreased performance in postoperative season 1; athletes in the Achilles tendon repair and tibia IMN cohorts recovered to baseline performance, while those in the ACL reconstruction and patellar tendon repair cohorts did not. Read more…
Read the abstract…
Study: Increased physical activity linked to improved bone strength in school-age girls.
According to a study conducted in Sweden and published online in the journal Calcified Tissue International and Musculoskeletal Research, an increase in physical activity among school-age girls may be associated with increases in bone strength and thickness. The authors reviewed information on 261 children participating in a prospective, controlled, physical activity intervention study. Overall, 170 children (72 girls and 98 boys) were provided with 200 minutes of physical education per week, while 91 children (44 girls and 47 boys) continued with a standard of 60 minutes. At 7-year follow-up, the authors found that girls in the intervention group had 2.5 percent greater cortical thickness and 6.9 percent greater polar stress–strain index (SSI) at the 66 percent tibia, which was accompanied by significantly greater pericortical volumetric bone mineral density compared to those in the control group. They found no group differences at the 14 percent tibia site in girls, and no group differences in any of the bone parameters in boys. Read more…
Read the abstract…
Health system argues that CMS and DOJ should not challenge physician judgment regarding hospital stays.
Modern Healthcare reports that healthcare system is challenging the U.S. Department of Justice (DOJ) over the agency’s use of a whistleblower lawsuit to challenge physician judgment over inpatient and outpatient hospital admissions. CMS criteria state that physicians should admit beneficiaries for inpatient treatment if they need more than 24 hours of care, and that outpatient observation stays should be used for treatment that will last less than 48 hours. A whistleblower working for the healthcare system alleged false claims stemming from patient visits that lasted less than 24 hours. The health system argues that CMS standards for inpatient and outpatient admissions are confusing and subjective, and that DOJ improperly questioned physicians’ subjective judgment on patient treatment. Read more…(registration may be required)
Academy CEO Karen Hackett announces retirement.
Karen L. Hackett, FACHE, CAE, has announced that she will retire from her position as chief executive officer (CEO) of the American Academy of Orthopaedic Surgeons, effective April 14, 2017.
Over the course of her tenure, Ms. Hackett has overseen a number of major developments at the Academy, including the opening of the new orthopaedic headquarters in Rosemont, Ill., in 2015. She has worked directly with the Board of Directors and executive management team to oversee a staff of 250 employees and manage an annual budget of $60 million.
“Karen’s leadership has been instrumental to the Academy’s success and growth,” said AAOS President Gerald R. Williams Jr., MD. “Thanks to her bold vision, valuable insights, and exceptional dedication, the Academy has created educational programming and new initiatives that continue to support and champion our members, all while navigating unprecedented change in the healthcare arena.”
The Board of Directors has retained an executive search firm to lead the search for a new CEO.
“I have been so proud to be the CEO of an organization representing such a devoted, dedicated, and driven group of physicians,” said Ms. Hackett. “I thank the AAOS Board of Directors, volunteers, members, and staff for the opportunity to serve this dynamic organization.”
