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2019 proposed budget suggests 21 percent cut to HHS overall, but some agencies would see funding gains
President Donald J. Trump has released a 2019 budget proposal that includes a 21 percent reduction in funding for the U.S. Department of Health & Human Services (HHS). An article in The Hill breaks down some of the changes, including the following:
  • $11 billion for the U.S. Centers for Disease Control and Prevention, a cut of about $900 million
  • $35.5 billion for the National Institutes of Health, an increase of $1.4 billion
  • $5.8 billion for the U.S. Food and Drug Administration, an increase of $673 million
  • An overall $10 billion HHS-wide investment in fighting the opioid crisis
An article in HealthLeaders Media notes that although the U.S. Congress "is unlikely to vote on a singular budget, the various provisions listed in the executive proposal outline the legislative agenda the Trump administration would like to pursue in 2018."
Other News
House subcommittee examines consolidation trends in health care
The U.S. House of Representatives Energy and Commerce Subcommittee on Oversight and Investigations held a hearing reviewing consolidation trends in the healthcare sector, the reasons behind those trends, and the effects they have on cost and quality of care. The American Association of Orthopaedic Surgeons (AAOS) provided comments on some of the testimony heard in the meeting. Among other things, AAOS advocated for a more site-neutral payment policy and removal of limits on physician-owned hospitals. In addition, AAOS noted concerns regarding the McCarran-Ferguson Act, "which effectively exempts insurance companies from the very antitrust laws all physicians are required to follow," and which has been linked to consolidation and concentration within the health insurance industry.
President names "drug czar" to oversee drug policy office
President Donald J. Trump has nominated James Carroll to serve as Deputy Director and Acting Director of the Office of National Drug Control Policy. Modern Healthcare notes that the position, sometimes referred to as "drug czar," will make Mr. Carroll "the most public face of the administration's efforts to fight the opioid epidemic." Mr. Carroll previously served as Assistant to the President and Deputy Chief of Staff. He worked for the Ford Motor Company prior to joining the Trump administration and has also worked for the U.S. Department of Justice and the U.S. Department of the Treasury.
Read more…  (registration may be required)
Study: What is the long-term impact of surgical versus nonsurgical treatment of ACL rupture?
A study published online in The American Journal of Sports Medicine examines long-term outcomes for surgical and nonsurgical treatment approaches to anterior cruciate ligament (ACL) rupture in high-level athletes. The authors conduced a retrospective, pair-matched, follow-up study of 50 high-level athletic patients with ACL rupture treated either surgically with an arthroscopic transtibial bone–patellar tendon–bone technique (n = 25) or nonsurgically with structured rehabilitation and lifestyle adjustments (n = 25). At 20-year follow-up, the authors identified knee osteoarthritis in 80 percent of the surgical cohort and 68 percent of the nonsurgical cohort. They found no significant difference across cohorts in functional outcomes or meniscectomy performed. However, 21 patients (84 percent) in the surgical group and 5 patients (20 percent) in the nonsurgical group had a normal or near-normal International Knee Documentation Committee score, pivot-shift test finding was negative in 17 patients (68 percent) in the surgical group and three patients (13 percent) in the nonsurgical group, and the Lachman test finding was negative in 12 patients (48 percent) in the surgical group and one patient (4 percent) in the nonsurgical group.
Study: Scoliosis questionnaire may be valid for outcomes assessment of pediatric patients with EOS
According to a study published in the March issue of the Journal of Pediatric Orthopaedics, the Early-Onset Scoliosis Questionnaire (EOSQ-24) may be a valid tool to evaluate patient-reported outcome measures among patients with early-onset scoliosis (EOS). The researchers administered the EOSQ-24 to caregivers of 65 pediatric patients with EOS. They found that the EOSQ-24 pulmonary function subdomain score positively correlated with pulmonary function testing values, and the EOSQ-24 scores for neuromuscular patients were significantly decreased compared with idiopathic or congenital/structural patients. The researchers state that internal consistency reliability of patients’ health-related quality of life (HRQoL) was excellent, but Family Burden was questionable, suggesting that "Parental Burden and Financial Burden should be in separate domains." They note that all EOSQ-24 domains demonstrated good to excellent agreement between test and retest scores, and the tool responded to different trajectories of HRQoL according to etiology in patients with EOS.
In the States
HealthLeaders Media reports that the U.S. Federal Trade Commission (FTC) has testified in the Alaska State Legislature in favor of repealing the state’s certificate of need (CON) laws. A spokesperson for FTC noted that the laws were enacted with the goal of reducing healthcare spending and access to care, but testified that CON laws may impose barriers to entry and expansion, enable existing organizations to block or delay competition, and withhold from consumers certain legal remedies following an anticompetitive merger. Supporters of the laws argued that Alaska’s rural populations and unique geography necessitate protections not provide by the free market.
Call for volunteers: CMS team to develop inpatient outcome measures for MIPS
AAOS seeks to nominate a liaison to participate in a team to develop inpatient outcome measures for the Merit-based Incentive Payment System (MIPS). The U.S. Centers for Medicare & Medicaid Services (CMS) has contracted with a private organization to adapt claims-based hospital measures to assess quality of care provided to Medicare beneficiaries by clinicians participating in MIPS. One of the measures to be adapted is the existing hospital-level measure, "Risk-Standardized Complication Rate Following Elective Primary Total Hip Arthroplasty (THA) and/or Total Knee Arthroplasty (TKA)," which will assess each clinician’s complication rate relative to that of other MIPS-participating clinicians with similar patients. Applicants for this position must be active fellows, candidate members, candidate members osteopathic, candidate member applicants for fellowship, or candidate member applicants for fellowship osteopathic. In addition, all applicants must provide the following: an online AAOS CAP application, a current curriculum vitae, a 100-word biography, and a letter of interest highlighting his or her expertise in the subject area. All supporting materials must be submitted to Kyle Trivedi by Feb. 15, 2018, at 11:59 p.m. CT, at:
Learn more and submit your application…  (member login required)
AAOS Headline News Now is a thrice-weekly member service produced by the AAOS Publications Department.
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