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Today's Top Story
Physicians concerned about delayed Medicare payments.
Other News
AOA creates independent grants organization.
Diagnostic imaging on the rise; insurers respond with tighter scrutiny.
Steep rise in knee replacements projected.
Healthcare reform on congressional to-do list.
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Now is the time to complete your OSAE.
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Physicians concerned about delayed Medicare payments.
According to the Los Angeles Times, millions of dollars in Medicare reimbursements remain outstanding, due to a backlog in claims processing. Some providers haven't been paid in months, and the lack of reimbursement is threatening not only patient care but also provider solvency. Observers blame the delays on factors such as the May 2008 switchover to National Provider Identifiers (NPIs), new claims processing contractors, and in some cases, data errors such as not processing a change of address.
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AOA creates independent grants organization.
An organization created by the American Orthopaedic Association (AOA) will provide funding for post-graduate orthopaedic fellowships and residency programs starting with the 2009-2010 academic year. The OMeGA Medical Grants Association LLC will independently receive and analyze funding requests before making grants to eligible programs and educational institutions. The board of directors of OMeGA will be selected using criteria to ensure that individuals to meet rigorous standards of independence. Orthopaedic manufacturer Zimmer Holdings, Inc. (Warsaw, Ind.) has signed on as a founding supporter of the new entity.
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Diagnostic imaging on the rise; insurers respond with tighter scrutiny.
Diagnostic imaging has been called the biggest driver of increasing healthcare costs. A study published in the November/December 2008 issue of the journal Health Affairs reviews data covering about 5 million radiology tests among 377,000 patients enrolled in the Group Health Cooperative in the state of Washington between 1997 and 2006. The authors found that the average total imaging cost per patient/year doubled during the study period, from $229 to $443. Study results showed the per-patient number of computed tomography (CT) scans doubled over the 10 years, and the number of magnetic resonance imaging (MRI) scans tripled across the board, with no single patient group or disease group dominating. According to the researchers, newer tests are being conducted in addition to, rather than instead of, older tests, leading to an increase in costs.
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The Wall Street Journal reports that some health insurers have hired outside firms to serve as radiology benefits managers (RBMs) to ensure that physicians use high-tech scans such as CTs and MRIs only when patients will clearly benefit from them. According to some physicians, however, the RBMs' review procedures can result in delays or rejections that sometimes pose risks for patients, waste staff time, and force physicians to justify decisions to reviewers who haven't seen the patients.
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Steep rise in knee replacements projected
According to a report in the November issue of the Mayo Clinic Women's HealthSource, the number of knee replacements is expected to increase 525 percent by 2030. The following reasons are among those given for the increase:
* People are living longer and, to remain active, want the procedure done sooner rather than later. * An increasing number of people have advanced arthritis, which could be related to ever-rising rates of obesity. * The designs of artificial knees have been improved so that they can be adapted to the patient's needs and size. * Minimally invasive knee replacement allows for smaller incisions and may facilitate faster recovery times. * Studies show that many people who have total knee replacement achieve significant pain relief, improved mobility, and better overall quality of life.
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Healthcare reform on congressional to-do list.
The Kaiser Daily Health Policy Report has gathered links to a number of stories on efforts in the U.S. Congress toward comprehensive health reform legislation in the wake of the presidential election. Recent updates include:
* A plan to develop and pass legislation based on President-elect Barack Obama's health care proposal to expand health coverage to more U.S. residents * A white paper to be released next week by the chair of the Senate Finance Committee regarding specific policy issues and proposals seen as priorities for the newly elected Congress * A proposal for expansion of the State Children's Health Insurance Program * A report that funds for state Medicaid programs that may be part of a new economic stimulus package
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Now is the time to complete your OSAE.
The initial scoring of the 2008 Orthopaedic Self-Assessment Examination (OSAE) is planned for the end of November. The Evaluation Committee encourages AAOS members to complete the examination and submit their electronic answer sheet by November 28, 2008. A sufficient number of responses is required to ensure that the statistical data renders a comprehensive analysis of examination items, as well as to establish a reliable norm group for the initial scoring. For more information related to this scoring, please contact the AAOS Evaluation Department, 6300 N. River Road, Rosemont, IL 60018, (1-800-346-2267).
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AAOS Headline News Now is a thrice-weekly member service produced by the AAOS Publications Department.
Disclaimer: The American Academy of Orthopaedic Surgeons is not responsible for the privacy policy, the content or the accuracy of any Web site accessed through a link on the AAOS Web site. A link to other Web sites does not constitute an endorsement by the AAOS of the linked site, its products or services.
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