Board approves position statements - AAOS Report

Board approves on-call, gainsharing position statements; reviews CMS decision on work values

The Boards of Directors of the American Academy of Orthopaedic Surgeons and the American Association of Orthopaedic Surgeons (AAOS), during their meeting in Rosemont, Ill., Sept. 15-16, approved position statements on “On-Call Coverage and Emergency Care Services in Orthopaedics,” and “Gainsharing.”

In addition, the Boards discussed the efforts by the AAOS and the American Association of Hip and Knee Surgeons (AAHKS) to reverse the proposal by the Centers for Medicare and Medicaid Services (CMS) to reduce the work values for total hip arthroplasty (THA), total knee arthroplasty (TKA) and hip fracture treatment. The Boards also held a strategic discussion on the Academy’s role in educating orthopaedic surgeons on appropriate relationships with industry.

Richard F. Kyle, MD, president, reviewed the AAOS/AAHKS joint efforts to retain current work values for THA, TKA and hip fracture treatment. In a letter to CMS administrator Mark B. McClellan, MD, PhD, the AAOS and AAHKS reviewed the method used to develop the work RVUs for these three procedures in an attempt to clarify any misunderstandings. The AAOS will continue to work with CMS to ensure that the concerns of orthopaedic surgeons regarding quality and access are heard. AAOS will notify members as soon as a final decision is reached.

James H. Beaty, MD, first vice president and chair of the Project Team on Trauma Care/On-Call issues, presented the position statement on “On-Call Coverage and Emergency Care Services in Orthopaedics,” which was approved. The October Bulletin will include a special section on trauma care and on-call issues, and will reprint both the new AAOS position statement and the Orthopaedic Trauma Association statement.

David A. Halsey, MD, chair of the Council on Advocacy and the Gainsharing Project Team, presented a position statement on “Gainsharing.” Because “supply-based purchasing agreements” typically involve exclusive contracts and limitations on the types of supplies and devices used, the position statement notes that physicians should be involved in their development, but that any cost-savings realized should be used to enhance patient care and not distributed directly to physicians. Both statements will be posted on the AAOS Web site, in the “About AAOS” section.

Dr. Halsey also presented a “Unified Advocacy Agenda,” which prioritizes all relevant topics in which the AAOS in engaged. He also discussed a bipartisan comprehensive musculoskeletal legislative package currently being developed.

Second Vice President E. Anthony Rankin, MD, reviewed the results of the first member needs assessment, conducted as part of the “AAOS in 2010” initiative, in preparation for a follow-up survey to be conducted in 2007.

During the strategic discussion on relationships between individual surgeons and industry, Matthew S. Shapiro, MD, chair-elect of the Board of Councilors, noted the importance of interacting with industry for improvements in patient care, and stated these relationships should be clearly outlined and meet legal and ethical guidelines.

A full report on the meeting will be included in the October Bulletin.

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