On the Horizon: NOLC Speakers Detail Changes in Payment Models

Shreyasi Deb, PhD; Matthew Snider, Esq.

U.S. baby boomers could push ‘cross-border shopping’ for health care in Canada to 15 percent A symposium presented at the National Orthopaedic Leadership Conference in June reviewed current payment models, both in the United States and abroad, as well as possible changes on the horizon.

Surgeons Share ‘Pearls’ for Providing Disaster-relief Orthopaedics

Maureen Leahy

Lessons learned from home and abroad Orthopaedic surgeons shared their first-hand experiences with disaster response, lessons learned, and suggestions for how to respond to future disasters during a symposium on disaster-relief orthopaedics at the recent National Orthopaedic Leadership Conference in Washington, D.C. Andrew N. Pollak, MD, chair of orthopaedics for the University of Maryland School of Medicine, recounted the health system’s experiences in Haiti following the 2010 earthquake.

PAC Awards Presented at NOLC

During the National Orthopaedic Leadership Conference (NOLC) in Washington, D.C., Orthopaedic Political Action Committee (PAC) Chairman John T. Gill, MD, presented the Stuart L. Weinstein awards. The annual awards, established in 2013, recognize the individual state with the highest PAC participation rate, and the state that demonstrates the greatest improvement in PAC participation from one year to the next.

Second Look—Advocacy

The Centers for Medicare & Medicaid Services (CMS) released Open Payments data for 2017. Data were disclosed by 1,525 manufacturers and group purchasing organizations related to payments and transfers of value provided to physicians and teaching hospitals, as well as ownership or investment interests held by physicians and their immediate families. CMS reported an $8.40 billion value in more than 11.5 million records, which is slightly lower than the previous two years.

Perspectives on Out-of-network Billing

Lee M. Reichel, MD; Robert Strauch, MD; Gregg Vagner, MD

Out-of-network (OoN) billing, or “surprise billing” consisting of unexpected charges for OoN services, is an increasingly recognized issue. In the past several years, some states have enacted laws to remediate the problem. In 2015, New York enacted a surprise-billing law that prevents patients with health insurance from having to pay more than their in-network copay when receiving emergency services from an OoN provider at an in-network facility.