AAOS Now, December 2014
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A Closer Look at Congressional Races
On midterm election night, Nov. 4, 2014, the most closely watched event of the evening was the race for control of the U.S. Senate. Republicans won, sometimes with surprising leads. In addition, the GOP extended its hold on the House with wins over several vulnerable “blue dog” (fiscally conservative) Democrats. Here’s a summary of some of the most interesting races.
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AAOS Hosts Congressional Tour of NIAMS Labs
While their bosses were home campaigning for reelection in October, several congressional staffers attended the 2014 Congressional Tour Day: Inside the NIAMS Labs, an event hosted by the American Academy of Orthopaedic Surgeons (AAOS) and other organizations belonging to the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Coalition.
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Bundled Pricing for Orthopaedic Services
When a patient undergoes an episode of care, Medicare and most commercial payers reimburse the hospital, surgeon, and postdischarge providers using separate and unique payment systems. For example, when a surgeon performs a total hip replacement (THR), the hospital is reimbursed based on the medical severity adjusted diagnosis-related group (MS-DRG) code for major joint replacement.
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AAOS Hosts Orthopaedic Quality Institute
Each year, the AAOS hosts the Orthopaedic Quality Institute (OQI) in Washington, D.C. The OQI brings together members of the orthopaedic community and other stakeholders—including payers, purchasers, healthcare policymakers, industry representatives, and patient advocacy groups—to discuss strategies for improving quality and measuring outcomes in musculoskeletal care. Increasingly, both the way and the environment in which physicians deliver and get paid for healthcare services are changing.
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PAC Event Will Feature Rep. Joe Heck, MD
Rep. Joe Heck, MD, (R) of Nevada’s 3rd Congressional district, will be the guest speaker for a luncheon on March 27, 2015, during the AAOS Annual Meeting. The luncheon will be hosted by the American Association of Orthopaedic Surgeons (AAOS) Ambassadors and the Orthopaedic Political Action Committee (PAC) Capitol Club, two groups that play crucial roles in AAOS advocacy efforts. Rep.
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State Races Will Impact Health Care
With the 2014 election results in, Republicans will soon occupy the governor’s mansion in 31 of the 50 states. Republicans won governor races in traditionally “blue” states such as Massachusetts, Maryland, and Illinois. Tom Corbett of Pennsylvania was the only Republican governor to be defeated. In Vermont, incumbent Gov. Peter Shumlin (D) received the most votes, but not a majority of those cast, as required by state law.
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Retail Health Care: Update on Trends in Healthcare Delivery
Healthcare reform has spurred novel approaches to both care delivery and reimbursement. Much of the focus has been on the Accountable Care Act (ACA), but the commercial market for health care has also changed radically. The accelerating expense of providing healthcare benefits to employees has been a driving force for many employers to identify coverage options that give individual employees more “skin in the game.”
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CMS Releases 2015 Fee Schedule Final Rule
The Centers for Medicare and Medicaid Services (CMS) releases its Physician Fee Schedule (PFS) final rule each year, bringing with it changes to physician reimbursement and a variety of related programs. The final rule for year 2015 was released on Oct. 31, 2014, with changes to physician fees, Medicare’s Physician Quality Reporting System (PQRS), the electronic health records (EHR) Meaningful Use program, and other quality and payment initiatives.
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Midterm Elections Flip Senate, Shift Priorities
Although a handful of races are yet to be determined, Republicans have decidedly taken control of the U.S. Senate, extended their majority in the House of Representatives, and won a number of governor’s races that were considered toss-ups until the last minute.