Orthopedics
Complications higher with regional anesthesia for hip fractures
Editor's Note In this study, patients having hip fracture surgery under regional anesthesia had significantly more complications than patients who received general anesthesia. Spinal anesthesia had the highest complication rate (19.6%), followed by general anesthesia (17.9%), and regional nerve blocks (12.6%). After combining regional nerve block and spinal anesthesia patients,…
CMS proposes major initiative for total joints
Editor's Note The Centers for Medicare & Medicaid Services is planning to require more than 800 hospitals in 75 geographic areas to participate in a bundled payments initiative for hip and knee replacements. These procedures are among the most common that Medicare beneficiaries receive, and prices vary significantly across geographic…
Avera McKennan finds innovative strategies to address orthopedic pain management
Postsurgical pain scores are highly correlated with reports of overall patient satisfaction during hospital stays, according to a poster presented at the 2014 American Academy of Pain Medicine annual meeting. Dermot Maher, MD, and his colleagues from Cedars Sinai Medical Center in Los Angeles examined patient responses on HCAHPS (Hospital…
Hybrid medical leadership turns competitors into collaborators
Solid teamwork and a commitment to high-quality patient care are the hallmarks of a successful healthcare facility. But egos sometimes get in the way, and competition among surgeons in the orthopedic service line at St Louis-based SSM Health Care was impeding progress. The surgeons were affiliated with three independent groups,…
Prepare now for more stringent joint replacement documentation requirements
Medicare administrative contractors (MACs) in several states recently ratcheted up their documentation requirements for joint replacement surgery and other orthopedic procedures. For hospital ORs, these changes represent the tip of an iceberg that calls for careful navigation. Enhanced medical necessity documentation requirements were launched in Florida in 2011. The state’s…
Orthopedic hospital uses 'price point' strategy to lower implant costs
Total joint arthroplasty volumes have ballooned in the last two decades, and reimbursement has not kept pace with costs. Rising implant prices are a major driver of hospital spending on these procedures. As the aging US population creates growing demand for joint replacement, controlling implant costs is becoming a top…
Boomer business: Lean strategy turns total joints into thriving enterprise
More than 7 million Americans are living with a prosthetic knee or hip, and there is a growing incidence of adults younger than 65 undergoing these procedures, researchers reported at the 2014 annual meeting of the American Academy of Orthopaedic Surgeons in March. Among those over 50 years of age,…
Survey finds surgeons largely unaware of orthopedic device costs
More than $150 billion is spent annually on medical devices in the United States, with orthopedic and cardiac procedures accounting for almost all of Medicare’s device-related expenditures. Most of the recent increases in such expenditures have been related to the wider use of orthopedic devices, which is expected to grow…
Faster discharge typical for patients undergoing hip surgery at ASCs
Innovations in surgical techniques, anesthesia, and equipment, along with the drive to decrease healthcare costs, are increasing the number of patients and procedures deemed suitable for outpatient surgery. Among the elective procedures now being performed at ambulatory surgery centers (ASCs) are total joint replacements. The buzz at recent conferences has…
Reducing variation in total knee replacements
A new study in the journal Health Affairs of total knee replacement (TKR) confirms that wide variations in care exist among hospitals based on factors such as geographic location. The High Value Healthcare Collaborative found significant variations in TKR among the 5 participating health care systems. Among these were length…
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