Dear NVOS Members,
The articles contained in this e-newsletter are excerpted from AAOS newsletters and other media sources to help our members stay current on national issues.
The NVOS Staff |
NYT Article Looks At Medical Device Pricing In The United States
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An article in the New York Times (NYT) looks at the issue of device  implant costs, and focuses specifically on orthopaedics. The author profiles several patients, including one who was quoted a price of $13,000 for a hip replacement. When the hospital's finance office estimated that the hospital charges would run another $65,000, the patient elected to have procedure performed in Belgium for $13,660. The author states that the American healthcare market is subject to what she terms "sticky pricing," in which "prices of products remain high or even increase over time instead of dropping." The author argues that pricing nondisclosure agreements between vendors and providers reduce the potential for competitive pricing. In addition, according to one industry source quoted in the article, there can be as many as 13 layers of vendors between the physician and the patient for a hip replacement.
The AAOS and the American Association of Hip and Knee Surgeons have responded to the article with a letter to the editor, calling attention to the disparity between the charges cited in the article and average Medicare reimbursements for the procedures.
Read more...
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SGR Repeal Bill Passes Committee With Unanimous Vote
| Modern Healthcare reports that the U.S. House of Representatives Energy and Commerce Committee has unanimously passed bipartisan legislation to repeal the Medicare Sustainable Growth Rate (SGR) formula and replace it with a stable system of payments to the nation's physicians. If enacted in its current form, the proposal would provide 5 years of stable Medicare payments starting in 2014, with reimbursements increasing by 0.5 percent each year until 2018. The 5-year period would allow physicians to transition to a new system in which they could choose among fee-for-service, reimbursement based on performance on quality measures, or certain alternative payment models. However, the bill does not yet include the financial offsets needed to pay for permanent replacement of the SGR, which is currently estimated at $139 billion.
Read more...
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Physician Payments Sunshine Act Went Into Effect August 1
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 On Aug. 1, the Physician Payments Sunshine Act, a provision of the Affordable Care Act, went into effect. Under the Sunshine Act, group purchasing organizations (GPOs) and drug and medical-device manufacturers are required to report any "transfers of value" of $10 or more made to physicians and teaching hospitals. In addition, manufacturers and GPOs must report any ownership interest by physicians and by physicians' immediate family members. Data through the end of 2013 must be reported to the Centers for Medicare & Medicaid Services (CMS) by March 31, 2014, and will be publically accessible through an online federal database by Sept. 30, 2014. According to an article in Modern Healthcare, drug samples for patient use or coupons to receive a sample will not need to be reported.
Read more...(registration may be required)
An article in the March issue of AAOS Now offers an overview of the Sunshine Act.
Read more...
CMS has announced the availability of two free mobile device apps designed to assist physicians and industry in tracking financial relationships disclosed under the Sunshine Act.
Read more...
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House Bill Would Require Public Disclosure Of Medicare Physician Data
| Modern Healthcare reports that a bipartisan bill has been introduced in the U.S. House of Representatives that, if enacted, would require public disclosure of Medicare payment information on individual physicians and other healthcare providers and suppliers. The Medicare DATA Act proposes to amend federal public-information laws to remove a privacy loophole that prevents the release of physician-specific Medicare payment data. Supporters of the legislation say that such transparency could lead to closer scrutiny of high-cost physicians and provide insights into which Medicare physicians have the best clinical outcomes. Critics of the proposal argue that such data could be misleading and would violate the privacy of the physician-patient relationship. The publication notes that a similar bill is pending in the Senate, and one Senate spokesperson states that the final proposal may be added to legislation expected to address the Medicare Sustainable Growth Rate formula.
Read more...
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Physicians Continue To Migrate Away From Accepting Medicare
| An article in the Wall Street Journal looks at the issue of physicians  opting out of Medicare. According to CMS data, 9,539 physicians who had accepted Medicare patients in 2011 opted out of the program in 2012, an increase from 3,700 during 2009. Further, the paper reports that many physicians who continue to accept Medicare opt to limit the number of Medicare patients they treat. According to data from the American Academy of Family Physicians, the 81 percent of family physicians who accepted new Medicare patients during 2012 represented a decrease from 83 percent in 2010.
Read more...
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AMA And AHA Request Increased Flexibility In Transition To Stage 2 Of Meaningful Use
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HealthLeaders Media reports that the American Medical Association (AMA) and the American Hospital Association (AHA) have requested that the U.S. Department of Health and Human Services consider increased flexibility for providers to meet what the organizations call "all-or-nothing" requirements for the Medicare and Medicaid Electronic Health Records (EHR) Incentive Programs Stage 2 rules for meaningful use. AMA and AHA suggest:
- Providers be allowed at Stage 1 to meet requirements using either the 2011 certified Edition EHR, or the 2014 certified Edition EHR
- Establishment of a 90-day reporting period for the first year of each new stage of meaningful use for all providers, similar to what was done for Stage 1
- Greater flexibility to providers in meeting Stage 2 to ameliorate the "all-or-nothing" problem
- Extension of each stage of meaningful use to no fewer than 3 years for all providers
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Study Examines Medical Research Patterns And Attempts To Identify Low-Value Practices
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 Data published in the August issue of the journal Mayo Clinic Proceedings attempts to identify low-value medical practices and patterns of medical research. The research team reviewed all (n = 2,044) original articles published over a 10-year period in the New England Journal of Medicine, and classified articles into one of four types:
- "Replacement," when a new practice surpassed a standard of care
- "Back to the drawing board," when a new practice was no better than a current practice
- "Reaffirmation," when an existing practice was found to be better than a lesser standard
- "Reversal," when an existing practice was found to be no better than a lesser therapy
Of 363 articles that tested a standard of care, 146 articles (40.2 percent) reversed that practice and 138 articles (38.0 percent) reaffirmed it. Included among the reversals identified by the research team were studies involving arthroscopic surgery for knee osteoarthritis and vertebroplasty for osteoporotic fractures.
Read more...
Read the complete study (PDF)...
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REGISTER TODAY
for the 2013 NVOS Reno Regional Meeting
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NVOS
Reno Regional
Meeting
REGISTER HERE
September 18, 2013
Eldorado Hotel Casino
345 N Virginia Street
Reno, NV 89501
Keynote Speaker:
Michelle James,MD Chief of Orthopaedic Surgery, Shriners Hospitals for Children Northern California & Chief of Pediatric Orthopaedics, Dept. of Orthopaedic Surgery, University of California
Davis Health Systems
Guest Speaker:
Joe Hardy, MD
Nevada State Senator
"Lessons Learned From the 2013 Legislative Session"
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2013-2014 Board of Directors
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President
Eric Boyden, MD
Immediate Past President
Hugh Bassewitz, MD
Vice-President
Abdi Raissi, MD
Treasurer
Gregg Lundeen, MD
Secretary
Colby Young, MD
Members At Large
Holman Chan, MD
Jack Davis, MD
Chad Hanson, MD
Ronald Hillock, MD
Jedediah Jones, MD
Terrence Orr, MD
James Rappaport, MD
AAOS Board of Councilors
Hugh Bassewitz, MD,
Nevada Representative
Fred Redfern, MD,
Chair
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