Published 7/1/2018

Second Look - Advocacy

Medicare reimbursement

According to a study in the journal Orthopedics (online), Medicare reimbursement for many orthopaedic procedures has decreased. The researchwea reviewed Medicare Physician Fee Schedule Current Procedural Terminology code values for common orthopaedic and nonorthopaedic procedures between 2000 and 2016. After adjusting for inflation, they found that annual reimbursements decreased over the study period for all orthopaedic procedures examined except for removal of orthopaedic implant. Orthopaedic procedures with the greatest mean annual decreases in reimbursement were shoulder arthroscopy/decompression, total knee arthroplasty (TKA), and total hip arthroplasty. Orthopaedic procedures with the least annual reimbursement decreases were carpal tunnel release and repair of ankle fracture. The researchers noted that the rate of reimbursement change varied across orthopaedic specialties, with trauma experiencing the smallest reductions and adult reconstruction having the greatest.

Physician report cards

A report published in JAMA Cardiology suggests a potential link between specialist attitudes toward public reporting requirements and clinical decision making. The authors surveyed 149 interventional cardiologists regarding avoidance of a common interventional procedure in a high-risk patient population. Sixty-five percent of respondents avoided administering a procedure on at least two occasions due to concerns that a poor outcome could negatively affect their public reports.

Medicaid coverage expansion

A report from the Urban Institute examined what would happen if the 19 remaining states that have not expanded Medicaid under the Affordable Care Act did so. Highlights include the following:

  • Four and a half million more people would have health coverage in 2019.
  • The uninsured rate in those 19 states would drop from 16.9 percent to 12.6 percent.
  • Demand for uncompensated care would decrease by $8 billion.

These items originally appeared in AAOS Headline News Now, a thrice-weekly enewsletter that keeps AAOS members up to date on clinical, socioeconomic, and political issues, with links to more detailed information. Subscribe at www.aaos.org/news/news.asp (member login required).