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 |
| AAOS Releases Choosing Wisely List Of Tests And Procedures That May Not Be Necessary In Orthopaedics | |
As a partner in the ABIM Foundation's Choosing Wisely campaign,  AAOS has released its own list of commonly ordered tests and procedures that may not always be necessary. The list identifies the following five targeted, evidence-based.
- Avoid performing routine postoperative deep vein thrombosis ultrasonography screening in patients who undergo elective hip or knee arthroplasty.
- Don't use needle lavage to treat patients with symptomatic osteoarthritis of the knee for long-term relief.
- Don't use glucosamine and chondroitin to treat patients with symptomatic osteoarthritis of the knee.
- Don't use lateral wedge insoles to treat patients with symptomatic medial compartment osteoarthritis of the knee.
- Don't use post-operative splinting of the wrist after carpal tunnel release for long-term relief.
The AAOS list was developed after months of careful consideration and review, using the most current evidence about management and treatment options. AAOS routinely develops evidence-based clinical guidelines and appropriate use criteria to enhance the diagnosis and treatment of musculoskeletal conditions. The topics selected for the Choosing Wisely campaign were selected from those guidelines. More than 50 medical societies have joined the campaign since it was launched in 2012.
Read more...
View the AAOS Choosing Wisely list...
Learn more about the Choosing Wisely campaign...
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| Study: Private Payer Reimbursement For Routine Office Visits Varies Widely; Difference Only Partially Explained By Geographic Area | |
A study published in the September issue of the journal Health Affairs finds wide variation in reimbursement by private insurers for routine physician office visits. The researchers conducted a retrospective analysis of more than 40 million insurance claims for routine office visits, consultations, and preventive visits during 2007. They found that physicians at the high end of the payment distribution were generally paid more than twice what physicians at the low end were paid for the same service. The researchers state that about one-third of variation could be linked to geographic area, but little variation was explained by patient age or sex, physician specialty, place of service, whether the physician was a network provider, or type of insurance plan. The researchers state that more data on the specific causes of price variation are needed to determine appropriate policy responses.
Read the abstract...
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| CBO: House Bill To Repeal SGR Would Cost $175 Billion Through 2023 | |
 According to a cost estimate from the U.S. Congressional Budget Office (CBO), passage of the Medicare Patient Access and Quality Improvement Act of 2013 (H.R. 2810) would increase federal spending by $175 billion by 2023. If enacted, the act would replace the Medicare Sustainable Growth Rate (SGR) formula with an alternative system that would give providers reimbursement increases of 0.5 percent each year from 2014 through 2018. In 2019, physicians could choose to report certain quality measures and have traditional fee-for-service payments adjusted based on how they compare with their peers on those measures, or opt out of that model if they participate in an alternative payment system such as a patient-centered medical home, accountable care organization, or other yet-to-be-determined system. CBO had earlier estimated the cost of an SGR repeal at $138 billion, but H.R. 2810 adds several new areas of spending. Current congressional rules require lawmakers to balance any new spending through spending cuts or increased revenues.
Read more...
Read the CBO cost estimate (PDF)...
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| Another Survey Finds Hospital Recruitment Of Physicians On The Rise | |
A report released by Merritt Hawkins & Associates reviews trends in physician hiring and recruiting incentives, and finds that 64 percent of physician search assignments from April 1, 2012, to March 31, 2013, came from hospitals. In 2004, hospitals generated just 11 percent of physician searches. "The recruitment of physicians into independent practice settings such as solo practice and partnerships has almost entirely abated," the authors write. In addition, the report finds increased demand for primary care and emergency physicians, while demand for radiologists and anesthesiologists has decreased. In addition, 75 percent of the company's 2012/13 search assignments featured a salary with production bonus, with the majority based on a Relative Value Units formula. The authors point out that a growing number of production formulas also feature quality-based metrics.
Read the report (PDF)...
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| HHS Website Offers Guidance On Managing Electronic Health Information | |
The U.S. Department of Health and Human Services (HHS) has  unveiled a new online resource designed to assist healthcare providers and patients with the management of electronic patient information. The Meaningful Consent site includes strategies and tools that can be used to engage and educate patients regarding health information exchange (HIE), and builds upon recommendations from the Health Information Technology Policy Committee. HHS states that the site also includes background, lessons learned, videos, and customizable tools from the HHS eConsent pilot project, which tested the use of tablet computers to inform patients about options available to them when they consider whether to electronically share their health information through HIE.
Read more...
View the Meaningful Consent site...
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| AAOS Board of Directors Approves AUC On Rotator Cuff Tears |
The AAOS Board of Directors has approved new appropriate use criteria (AUC) on "Optimizing the Management of Full-Thickness Rotator Cuff (RC) Tears." This is the second AUC released by AAOS, and is supported by both a written document and the AAOS mobile-optimized AUC web app. The AUC is based on a systematic review of the literature as well as clinician expertise from several specialties. It covers five treatments-nonsurgical modalities, partial repair and/or debridement, repair, reconstruction, and arthroplasty-and presents 432 different patient scenarios to help clinicians identify for whom and when the treatments are appropriate. The full AUC document is available through the mobile-optimized web app right now and will be posted to the main AAOS website on Monday, Sept. 23.
Learn more about AAOS AUCs ...
Visit the AUC web app...
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Efficiency Ratings Loom For Hospitals
|  Come Oct. 1, 2014, hospital reimbursement will in part be determined by efficiency measures, such as how much is spent per beneficiary and how well hospitals limit readmissions. This new scoring by the Centers for Medicare and Medicaid Services (CMS) is intended to assess how efficiently a provider organization delivers an episode of care, defined as the period starting 3 days before beneficiaries' hospital admissions and ending 30 days after discharge, for all services paid under Medicare Part A and Part B. Under this system, CMS will show how much was spent on average in seven categories: home health, hospice, inpatient, outpatient, skilled nursing, durable medical equipment, and carrier (physician, ambulatory surgical center), and how each tally compares to state and national spending. Although some administrators concede that the new metric provides a gauge of how well an institution is executing hospitalization and transition of care, critics say that much of what is being measured involves providers beyond a hospital's control, reports HealthLeaders Media.
Read more... |
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Visit The NVOS Website For The Latest Updates
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Thank You To Our 2013 Reno Regional Meeting Exhibitors
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Arthrex Auxilium Pharmaceuticals Mako Surgical Medtronic Spinal Pfizer Sanofi Biosurgery Smith & Nephew Stryker Synthes Zimmer TriMed- Sorensen Medical |
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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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