AAOS Commends CMS for Important Changes to Bundled Payment Models

Elizabeth Fassbender

On Aug. 15, 2017, the Centers for Medicare & Medicaid Services (CMS) announced a proposed rule that addressed significant concerns raised by the American Association of Orthopaedic Surgeons (AAOS) related to mandatory bundled payment programs. First, the proposed rule would reduce the number of mandatory geographic areas participating in the Center for Medicare and Medicaid Innovation's (Innovation Center) Comprehensive Care for Joint Replacement (CJR) model from 67 to 34.

Medicare Advantage Poses Challenges and Opportunities for Orthopaedic Surgeons

Wilford K. Gibson, MD, FACS, FAAOS, FAOA; John O'Shea, MD, MPA, FACS; Shreyasi Deb, PhD, MBA

Given the surge in Medicare Advantage (MA) enrollment, these plans may someday overtake traditional Medicare. Today, orthopaedic surgeons need to learn more about MA plans. When they evaluate plans and reimbursement fee schedules, surgeons should be aware of the differences between MA and traditional Medicare. This article provides an introduction to the MA program and how these plans affect orthopaedic practices, especially under the Quality Payment Program.

Orthopaedic Surgeons Clarify Differences Between Themselves and Podiatrists

Thomas Lee, MD; Jeffrey Johnson, MD; James Ficke, MD; Michael Aronow, MD

Policy battles in Washington, D.C., can seem very far away from the day-to-day activity of taking care of patients. Many of us chose this profession because we wanted to make a direct, immediate impact on people's lives. In contrast, the political process is slow-moving and often frustrating. However, orthopaedic surgeons can achieve real policy successes when we get involved.

Second Look – Advocacy

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). An article on ProPublica notes that, after consideration of public comments, the U.S.

Pharmacy Benefit Managers Play Significant Role in Drug Pricing

Judi Buckalew, BSN, MPH, CAE

Congress, state legislatures, and the White House are united in a quest to reduce prices for prescription drugs. As attention focuses on pricing transparency for drugs, the role that pharmacy benefit managers (PBMs) play in the pricing process is also under scrutiny. The complex nature of the prescription drug supply chain can be confusing, and the public may believe that drug companies are the primary cause of high drug prices.

Healthcare Reform: Where Do We Go from Here?

William J. Maloney, MD

In the April edition of AAOS Now, I commented that 2017 would no doubt be a major year for healthcare reform. Indeed, the intense focus on repealing and/or replacing the Affordable Care Act (ACA) has occupied much of the legislative and public debate thus far this year. After initially pulling a bill from the floor for a vote, the House of Representatives in May passed its version of the ACA repeal by a vote of 217–213, with 20 Republicans voting against.