Changing the 1099 provisions in PPACA

Lauren Bates

Even when all agree, making changes is difficult The Patient Protection and Affordable Care Act (PPACA, P.L. 111-148) includes many controversial provisions. Revising or repealing some of those provisions may be difficult, despite the results of the November election. Even when both Republicans and Democrats agree that a provision has onerous, unintended consequences, finding a solution may be challenging. One example is the new 1099 information reporting requirements for businesses.

The costs of defensive medicine

Carolyn M. Hettrich, MD, MPH; Richard C. Mather III, MD; Manish K. Sethi, MD; Ryan M. Nunley, MD; Amir A. Jahangir, MD; the Washington Health Policy Fellows

Did healthcare reform miss an opportunity to cut costs, improve access, and increase patient safety? A major area of concern for orthopaedic surgeons that was not addressed in the Patient Protection and Affordable Care Act was substantive medical liability reform. Although direct expenditures on medical liability account for only a small fraction of healthcare spending, much more is spent on the direct and indirect costs of defensive medicine.

Election 2010: Changing tide

Stuart L. Weinstein, MD

Not since 1994 has there been a more heated midterm election. The Republicans gained control of the House of Representatives and increased their numbers in the Senate. It is clear that jobs and the economy were at the top of Americans’ minds as they went to the polls on the first Tuesday in November. The increasingly unfavorable opinion about the healthcare reform law also played a major role in the voting patterns of Americans.

Advocacy: Your true calling

John D. Kelly IV, MD

Get involved—for your patients and yourselves “Act or be acted upon.” These words by Stephen R. Covey capture the essence of the need for advocacy. When we resign ourselves to the ‘status quo,’ we relinquish control of our lives, our destinies, and the welfare of our patients. We submit to those less informed or capable. When we watch from the sidelines, we forfeit responsibility and transfer power and influence into the hands of those who may act with less-than-pure intentions.

Collaborating on care, changing the culture

Alexandra Page, MD

ACO models provide a road map for change Primary Obstacles to Hospital-Physician Collaboration (PDF) Accountable care organizations (ACOs) share certain characteristics, but may take different forms. According to James T. Caillouette, MD, physician leaders can align their goals with a hospital to create an effective vertically integrated model. Dr. Caillouette and Richard F. Afable, MD, MPH, presented a model of integrated care in a private (nongovernment) setting.

Keeping our nation moving

Mary I. O’Connor, MD

By Mary I. O’Connor, MD Summit focuses on musculoskeletal health disparities As we strive to deliver the highest levels of patient care and surgical excellence, members of the orthopaedic profession often gather to discuss the challenges and opportunities facing us as individuals and as a community of surgeons. We appreciate this sharing of knowledge and experiences as a means to advance our goals.

Election Results Portend Change

Alanna G. Porter

The national midterm elections on Nov. 2 resulted in significant gains for the Republican party and will mean substantial changes in both houses of Congress. The impact of the election will be felt not only in how President Obama will have to change strategies to get legislation passed, but also in what legislation is addressed.

Time’s Running Out on SGR Fix

Mary Ann Porucznik

As this issue of AAOS Now goes to press, the “lame-duck” Congress seems set to approve another short-term fix for physician payments under the sustainable growth rate (SGR) formula for Medicare. On Nov. 18, the U.S. Senate unanimously approved a 1-month extension of the current patch, retaining the 2.2 percent update in physician payments through the end of the year.