Orthopedics
CMS finalizes changes to bundled-payment models
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on November 30 announced a final rule that cancels the mandatory hip fracture and cardiac bundled-payment models, which were to begin on January 1, 2018, and implements changes to the Comprehensive Care for Joint Replacement (CJR) Model. In the final…
AAAHC develops new Orthopaedic Certification for ASCs
Editor's Note The Accreditation Association for Ambulatory Health Care (AAHC) announced on November 2 that it has developed a new Orthopaedic Certification program for ambulatory surgery centers (ASCs). After an ASC achieves overall accreditation, it can acquire the Orthopaedic Certification to demonstrate excellence in the specialty of orthopaedics by meeting…
Total joint patients using fewer opioids to manage postop pain
Editor's Note Opioid use in total hip and knee patients decreased by one-third between 2006 and 2014, which reflects success in the use of a multimodal approach (ie, opioids plus additional pain management methods, such as peripheral nerve blocks and acetaminophen) to pain management, finds this study presented October 21…
Most hip fractures occur in warm months, indoors
Editor's Note Most elderly hip fractures occur during warm months, and a greater number happen indoors rather than out, finds this study presented October 23 at the Anesthesiology 2017 annual meeting in Boston. In this analysis of 544 hip fracture patients treated at The Hospital of Central Connecticut from 2013…
Factors linked to readmission after total hip
Editor's Note All-cause readmission is the only metric in widespread use, but it overlooks important information that enables readmission risk to be understood, this study finds. Of 514,455 patients in the UK analyzed over a 10-year period, there were 30,489 all-cause readmissions, 16,499 readmissions related to the surgical site, and…
Little change in physical activity after total joint surgery
Editor's Note Physical activity in total joint patients did not change at 6 months after surgery and small-moderate improvement was found at 12 months, despite large improvements in pain and quality of life, this meta-analysis finds. A total of seven studies (336 patients) were analyzed. Reasons for the lack of…
Effectiveness of drug-free interventions to reduce pain, opioids after total knee
Editor's Note In this meta-analysis of the effectiveness of nonpharmacological interventions for pain after total knee arthroplasty, electrotherapy and acupuncture were associated with reduced and delayed opioid consumption, but there was low or very low certainty that they improved pain. Continuous passive motion and preoperative exercise did not improve pain…
Orthopedic PSH a prime model for value-based care--Part 2
Organizations that have adopted the perioperative surgical home (PSH) model of patient care have reaped the benefits of improved outcomes and a healthier bottom line. In particular, the PSH has a proven track record for colorectal surgery and orthopedic surgery. In part 1 of this two-part series (OR Manager, August…
CMS proposes canceling two bundled payment models, scaling back a third
Editor's Note The Centers for Medicare & Medicaid Services (CMS) on August 15 announced a proposed rule that would cancel two bundled-payment models and reduce the number of providers required to participate in a third. The proposed rule would cancel the Episode Payment Models and the Cardiac Rehabilitation incentive payment…
Hospitals partnering with ASCs to perform outpatient total joints
Editor's Note With the growth of ambulatory surgeries and the shift to Medicare reimbursement for outpatient hip and knee replacements, hospitals are acquiring and forming joint ventures with ambulatory surgery centers (ASCs), the August 5 Modern Healthcare reports. This allows hospitals to keep part of the revenue and better aligns…
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