Published 6/1/2011

Second Look—Advocacy

If you missed these Headline News Now items the first time around, AAOS Now gives you a second chance to review them. Headline News Now—the AAOS thrice-weekly, online update of news of interest to orthopaedic surgeons—brings you the latest on clinical, socioeconomic, and political issues, as well as important announcements from AAOS.

More providers being paid for taking call
According to survey data released by the Medical Group Management Association (MGMA), 35 percent of healthcare providers reported receiving daily on-call compensation for the days they are on call, and 21 percent of providers reported receiving an annual payment for on-call coverage. Compensation varied by practice size, practice type, location, specialty, and holiday/weekend hours. “Medical Directorship and On-Call Compensation Survey: 2011 Report based on 2010 Data” used data from 3,084 on-call providers in 264 medical organizations and 1,529 medical directorships in 255 medical organizations.

FDA issues warnings on MRSA prevention products
The U.S. Food and Drug Administration (FDA) has sent warning letters to four manufacturers of products that claim to prevent infection from methicillin-resistant Staphylococcus aureus (MRSA). The firms include Tec Laboratories JD Nelson and Associates; Dr. G.H. Tichenor Antiseptic Co; and Oh So Clean, Inc. dba CleanWell Company.

The warning letters explain that the companies are marketing products in violation of federal law. FDA states that it does not have sufficient evidence demonstrating that these products are safe and effective for their claimed purposes.

Prescription confidentiality goes to Supreme Count
The New York Times
reports that the U.S. Supreme Court will hear arguments in a case that tests whether Vermont’s prescription confidentiality law violates constitutional free speech protections. The law is designed to prevent pharmaceutical companies from marketing to physicians based on prescription writing records. Maine and New Hampshire also have enacted laws to limit the use of prescription records for marketing.

Medical groups planning to hire more
According to a survey conducted for the American Medical Group Association (AMGA), 79 percent of medical groups plan to hire “more” or “significantly more” specialists in 2011. Additional trends noted in the survey include an increase in the percentage of male and female physicians practicing part-time and incentives to encourage physicians to delay retirement. Although 73.8 percent of responding groups believe mentoring reduces turnover, just 56.1 percent assign a mentor to newly hired physicians. The survey results are based on responses from 62 AGMA member groups.

Medicare attestation for EMR incentives begins
The U.S. Centers for Medicare & Medicaid Services (CMS) Web-based Medicare and Medicaid Electronic Health Records (EHR) Incentive Program Registration and Attestation System is now available to eligible hospitals, healthcare professionals, and critical access hospitals (CAHs) to begin applying for Medicare electronic medical record (EMR) incentive payments. To receive the incentive payments, providers must attest through the system. CMS has additional information about the Medicare attestation process, including user guides that provide step-by-step instructions for completing attestation, and educational events that describe the attestation process in depth. Previews and selected screenshots of the attestation system are available on the CMS Web site.

To prepare for Medicare attestation, providers will need to familiarize themselves with the required meaningful use criteria. Meaningful use requirements for eligible professionals, eligible hospitals, and CAHs participating in the Medicare EHR Incentive Program are different. For more information, visit the AAOS online practice management center, www.aaos.org/pracman

Bipartisan opposition to IPAB
The New York Times
reports that both Republican and Democratic legislators have voiced opposition to the Independent Payment Advisory Board (IPAB)—a panel of 15 experts created under the Patient Protection and Affordable Care Act (PPACA) to help control growth in Medicare spending. Beginning in 2015, if Medicare spending exceeds a specific target, the IPAB would have the authority to recommend cuts, which would take effect automatically unless Congress votes to block or change them.

Study: Self-referral linked to increased MRI use
A study published online in the journal Health Services Research suggests that orthopaedic surgeons and primary care physicians who self-refer for magnetic resonance imaging (MRI) procedures tend to use more MRI for patients with low back pain. The review of Medicare claims for a 20 percent sample of beneficiaries from 1998 to 2005 found that physician acquisition of MRI equipment strongly correlated with an increase in the number of patients receiving MRI scans.

Physician disciplinary actions by state
A report released by the non-profit advocacy group Public Citizen finds that the rate of serious disciplinary actions (revocations, surrenders, suspensions, and probation/restrictions) taken by state medical boards fell slightly in 2010. The analysis of data from the Federation of State Medical Boards found 2.97 serious actions per 1,000 physicians, compared to 3.05 such actions per 1,000 physicians in 2009.

Patients turning to EDs for health care
A survey by the American College of Emergency Physicians of 1,768 emergency department (ED) physicians finds that more than 80 percent report increased use of EDs, with about half reporting significant rises and more than 90 percent expecting ED use to increase over the next year. In addition, 97 percent of ED physicians reported treating patients on a daily basis who were referred to them by primary care physicians. Respondents attributed the overall increase in emergency patients to patients without health coverage (28 percent) and a growing elderly population (23 percent). About two-thirds of emergency visits occur after business hours, when physicians’ offices are closed.