" The Voice Of Interventional Pain Management "

celebrating our 10th anniversary

March 6, 2013


  1. Billions in Extra Cash Fail to Stop Rot in NHS
  2. FDA Warns Against Codeine for Children
  3. BCBSNC Kicks Off Orthopedic Bundles
  4. Revenue Can't Fix Bad Metrics; Only Strategy Can
  5. ObamaCare and the '29ers'
  6. Two Hill Panels to Examine Medicare Changes
  7. GAO Report : Obamacare Adds $6.2 Trillion to Long-Term Deficit
  8. Doctors Don't Trust Their Own Hospitals
  9. Hospitals Forge New Deals With Insurers
  10. Blog: Changing the Way Physicians Are Paid: Report of the National Commission on Physician Payment Reform
  11. Based on Massachusetts' Health Overhaul, What Can the Nation Expect in 2014?
  12. Empowered by ACA, Old Fraud Law Puts New Scrutiny on Doctors
  13. CMS: No More Delays with Move to ICD-10
  14. Newer Sleep Meds Still Carry Fall Risk in Elderly
  15. ASIPP Offers Pain Medicine and Anxiety Medicines Brochure to Members
  16. State Society News
  17. Physician Wanted 

billionsBillions in Extra Cash Fail to Stop Rot in NHS


Premature death rates from a series of conditions, including heart disease and breast cancer, are significantly higher in this country than in similarly developed nations such as France, Italy and Spain, researchers said in a report on Monday.


Although public health has generally improved, other countries have made greater progress, leaving Britain "persistently and significantly" lagging behind the EU and other global powers.


Life expectancy increased by 4.2 years to 79.9 between 1990 and 2010, but the UK still dropped from 12th to 14th on a list of 19 Western nations



The Telegraph

codeine FDA Warns Against Codeine for Children


Children shouldn't be given codeine to relieve pain after having their tonsils or adenoids removed because the medication can cause death, the Food and Drug Administration warned Wednesday.


The FDA said it would require all codeine-containing products to carry a boxed warning, the agency's toughest, to instruct doctors against use in children after such surgeries.


The agency said it received reports of 13 deaths of children who had surgery and got codeine-containing drugs afterward. A review of the deaths, which occurred from 1969 to 2012, found that most took place after surgery to remove tonsils and adenoids, and many of the children had sleep apnea.



Wall Street Journal

orthoBCBSNC Kicks Off Orthopedic Bundles


Blue Cross Blue Shield of North Carolina has just started testing out its bundled payment model for knee replacement surgeries, and if performs well, the model could be pushed out to include hip replacements.

Elaine Daniels, the plan's senior strategic network consultant, says BCBSNC started modeling orthopedic bundles in 2010, began a pilot project in 2011, and recently announced two bundled payment initiatives with physician-owned Triangle Orthopaedic Associates (TOA) and Duke University Health System.

"When you're looking at doing bundles on a first pass, orthopedic procedures were easier for us because there aren't that many complications," says Daniels. "There's not a lot of leakage, you know who the care team is going to be, so there's more continuity of care for that member or patient."


Health Leaders Media


revenueRevenue Can't Fix Bad Metrics; Only Strategy Can


In the business of healthcare, it's hard to escape the reality of reduced profitability as far as the eye can see. That dour outlook is being reflected in the bonds of nonprofit healthcare organizations. If you owe money to an individual or institution, they like to keep a close eye on the general health of the business, in addition to the individual market in which you operate.

And based on their calculations, all is not well.

A report this week from Moody's Investors Service revealed that 2012 was a record year in terms of the amount of hospital and health system debt downgraded. At $20 billion of nonprofit healthcare debt downgraded, 2012 represents the highest amount of downgraded debt since Moody's started tracking the metric in 1995, and is more than double the amount of upgraded debt (which is reflected in improving business trends).


Health Leaders Media


obamacareObamaCare and the '29ers'


Here's a trend you'll be reading more about: part-time "job sharing," not only within firms but across different businesses.


It's already happening across the country at fast-food restaurants, as employers try to avoid being punished by the Affordable Care Act. In some cases we've heard about, a local McDonalds has hired employees to operate the cash register or flip burgers for 20 hours a week and then the workers head to the nearby Burger King or Wendy's to log another 20 hours. Other employees take the opposite shifts.


Welcome to the strange new world of small-business hiring under ObamaCare. The law requires firms with 50 or more "full-time equivalent workers" to offer health plans to employees who work more than 30 hours a week. (The law says "equivalent" because two 15 hour a week workers equal one full-time worker.) Employers that pass the 50-employee threshold and don't offer insurance face a $2,000 penalty for each uncovered worker beyond 30 employees. So by hiring the 50th worker, the firm pays a penalty on the previous 20 as well.


Wall Street Journal

twoTwo Hill Panels to Examine Medicare Changes


With $85 billion in automatic federal spending cuts set to take effect on Friday and predictions of economic disruption, much of official Washington is focused on the "blame game." Publicly, there has been no sign that Congress or administration officials have made any progress on averting these cuts or finding common ground on tackling the country's fiscal problems.


But there are small signs that Democrats and Republicans are beginning to wrestle with the issue of what role Medicare should play in deficit reduction. Two Capitol Hill committees with jurisdiction over healthcare have scheduled hearings this week to examine Medicare's current benefit design and to review provisions in the 2010 healthcare law aimed at making the program more efficient.



MedPage Today

gaoGAO Report : Obamacare Adds $6.2 Trillion to Long-Term Deficit


Obamacare will increase the long-term federal deficit by $6.2 trillion, according to a Government Accountability Office (GAO) report released today.


Senator Jeff Sessions (R., Ala.), who requested the report, revealed the findings this morning at a Senate Budget Committee hearing. The report, he said, "confirms everything critics and Republicans were saying about the faults of this bill," and "dramatically proves that the promises made assuring the nation that the largest new entitlement program in history would not add one dime to the deficit were false."


President Obama and other Democrats attempted to win support for the health-care bill by touting it as a fiscally responsible enterprise. "I will not sign a plan that adds one dime to our deficits - either now or in the future," Obama told a joint-session of Congress in September 2009. "I will not sign it if it adds one dime to the deficit, now or in the future, period."


Report: http://global.nationalreview.com/pdf/gao_022613.pdf


National Review

doctorsDoctors Don't Trust Their Own Hospitals


Staff at North Cumbria University Hospitals and United Lincolnshire Hospitals are the least likely to recommend treatment, according to figures that are being scrutinised closely by ministers.


Less than 40 per cent of those employed at the trusts, both of which have relatively high death rates, would recommend the treatment available, compared with more than 90 per cent of staff at the top-rated hospitals.

Nationally, almost 40 per cent of NHS staff would not recommend the treatment available at their hospitals to their friends and family.


The Telegraph

hospitalsHospitals Forge New Deals With Insurers


Hospitals and health insurers are locking horns over how much health-care providers will get paid under new insurance plans that will be sold as the federal health law is rolled out.


The results will play a major role in determining how much insurers will ultimately charge consumers for these policies, which will be offered to individuals through so-called exchanges in each state.


The upshot: Many plans sold on the exchanges will include smaller choices of health-care providers in an effort to bring down premiums.



Wall Street Journal

blogBlog: Changing the Way Physicians Are Paid: Report of the National Commission on Physician Payment Reform


The loud cries warning that rising health care costs are going to destroy the nation's economy have been shouted so often that the will to move firmly in any one direction has almost halted. We've all heard them: health care costs are unsustainable, excessive spending is fueling our nation's debt, and despite high costs, health outcomes are behind much of the world and aren't improving.


The way doctors are paid is one of the most significant drivers of escalating health care costs. The National Commission on Physician Payment Reform, which we chair, was formed by the Society of General Internal Medicine to provide the public and private sector with recommendations for transforming the way we pay doctors in order to rein in spending and improve quality.



Health Affairs

basedBased on Massachusetts' Health Overhaul, What Can the Nation Expect in 2014?


For providers, payors, patients and politicians gearing up for changes called for in the Patient Protection and Affordable Care Act taking place next year, Massachusetts may offer some clues into what they can expect, according to a webinar led by Judith Bentkover, PhD, academic director of Brown University executive master 's program in healthcare leadership and president and CEO of healthcare consulting firm Innovative Health Solutions.

Four years before the PPACA was passed in 2010, Massachusetts signed its own massive health reform law, unprecedented anywhere else in the country at that point. That law, similar to the PPACA, required nearly every adult to purchase health insurance and introduced heavy government subsidies to help the poor afford coverage.

Dr. Bentkover says Massachusetts has since achieved near universal coverage - 98 percent of its residents are insured, she says, higher than any other state - with only "moderate" added cost to taxpayers, around $91 million per year after reimbursements. She adds much of that money goes to fund private subsidies to pay for private insurance, but that expense is largely offset by increased payments for uncompensated care by providers across the state.


ASC Review

empowerEmpowered by ACA, Old Fraud Law Puts New Scrutiny on Doctors


With the Affordable Care Act giving the government more power and dedicating more money to improving federal efforts against health care fraud, waste and abuse, physicians' business practices are under the microscope like never before.


While only a small fraction of physicians are engaged in fraudulent activity, all doctors face the new reality of increased scrutiny over billing, referral and coding activity, legal experts said.


But recognizing federal False Claims Act risks and enacting a strong compliance program can help doctors come through such reviews unscathed and thwart violations before they occur, said attorney Julie E. Kass, a principal in the Ober|Kaler Health Law Group based in Maryland. She spoke about the FCA and compliance steps for physicians at the American Health Lawyers Assn.'s Physicians and Physician Organizations Law Institute meeting February in Phoenix.


AMA news

cmsCMS: No More Delays with Move to ICD-10


Washington The mandated transition by billers throughout the health system to the more complex ICD-10 diagnosis codes will go forward without any further delays, the Centers for Medicare & Medicaid Services stated in a Feb. 6 letter to the American Medical Association.


Acting CMS Administrator Marilyn Tavenner made the case for moving forward with ICD-10 to modernize the health care system. Halting its implementation, which has been ongoing since 2009, would mean relying on outdated ICD-9 codes that soon will be incompatible with general health care needs and new technologies, she stated.


"Many in the health industry are under way with the necessary system changes to transition from ICD-9 to ICD-10," Tavenner wrote. "Halting this progress midstream would be costly, burdensome, and would eliminate the impending benefits of these investments. Many private and public sector health plans, hospitals and hospital systems, and large physician practices are far along in their ICD-10 implementation and have devoted significant funds, resources and staff to the effort."


AMA news

sleepNewer Sleep Meds Still Carry Fall Risk in Elderly


The use of nonbenzodiazepine sleeping medications -- intended to be a safer alternative than older hypnotics -- continues to place patients at risk for falls and hip fracture, a case-crossover study found.


The risk of a hip fracture among residents of nursing homes was 66% higher during the month after patients were given one of the newer insomnia medications (OR 1.66, 95% CI 1.45 to 1.90), according to Sarah D. Berry, MD, of Harvard Medical School, and colleagues.



MedPage Today

brochureASIPP Offers Pain Medicine and Anxiety Medicines Brochure to Members

ASIPP Marketing Services will be releasing a series of Interventional Pain brochures for purchase in the near future.


At this time ASIPP is offering a Pain Medicine and Anxiety Medicines brochure that you can tailor to your practice and make available to your patients and referring physicians.


We will send the brochure materials to your or to your printer and they can print and deliver them to you.


Either option offers an inexpensive and effective way to communicate medication Information to your patients and promote your practice. Brochures are copyrighted by ASIPP.


Contact Ray Lane via email at rlane@asipp.org for ordering information.




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