Banner
January 19, 2022 ACFAS.org | FootHealthFacts.org | JFAS | FASTRAC | Contact Us

News From ACFAS


Act Fast! Space is Limited for Coding and Billing
Time’s running out to secure your spot for the Coding and Billing for the Foot and Ankle Surgeon preconference workshop at ACFAS 2022 in Austin.

This interactive and comprehensive workshop covers pertinent issues related to properly coding surgical procedures and evaluation and management services. After this course you will leave knowing:
  • How to code more efficiently and effectively and will see an increase in reimbursements
  • Trends in surgical coding, including how to code for new advances in the practice of foot and ankle surgery
  • How to appropriately select modifiers for complex, staged, and multiple procedure cases
  • Where higher level E&M codes fit into your surgical practice
You will cover the cost of this course and see an immediate return on investment in your own practice simply by learning how to code just one or two procedures properly. Don’t miss this chance to get ahead with your coding. Register today at acfas.org/PracticeManagement.
Share Facebook  LinkedIn  Twitter  | Web Link
More Ways to Connect with 2022 Industry Events
What's an Annual Scientific Conference without a full line up of Industry Events? Whether it’s industry-sponsored breakfast labs, evening labs or the all-new Industry Innovations Theater in the Exhibit Hall, we have it all!

Visit acfas.org/Austin to check out the full list of this year’s Industry Events at ACFAS 2022!
Share Facebook  LinkedIn  Twitter  | Web Link
ACFAS Research Grant Awards Announced
Congratulations to the recipients of the ACFAS Clinical & Scientific Research Grant Program!

Thanks to support from PICA and the ACFAS Regions, in 2021 the College debuted an expanded grant program that provided funding of up to $75,000 for an established researcher and up to $25,000 for a new researcher. Twelve grant proposals were received and reviewed by an independent panel of content experts who selected the recipients:

Established Researcher
Naohiro Shibuya, DPM, MS, FACFAS; Javier La Fontaine, DPM, FACFAS and Daniel Jupiter, PhD
Trajectories of diabetes related sequelae for identifying transition probabilities, and optimal timepoints for prevention of ulceration, infection, and amputation

New Researcher
Peter A. Crisologo, DPM, FACFAS
Diabetic Foot Infection: Immune Status to Inform Outcome
Share Facebook  LinkedIn  Twitter 

Foot and Ankle Surgery


An Evaluation of Basic Demographic Characteristics in Foot and Ankle Surgery from the American College of Surgeons National Surgical Quality Improvement Program
An investigation conducted a descriptive analysis and compared basic demographic characteristics of foot and ankle surgery within the American College of Surgeons National Surgical Quality Improvement Program database. The 16 Current Procedural Terminology (CPT) codes within the database concerning foot and ankle surgery were analyzed, and several CPT codes were more frequently connected to male gender, including Achilles tendon repair, lateral ankle reconstruction, total ankle arthroplasty, open reduction and internal fixation (ORIF) medial malleolus fracture, ORIF lateral malleolus fracture and metatarsal amputation. Other CPT codes seen as more frequently associated with female gender included primary peroneal tendon repair, ORIF bimalleolar fracture, ORIF trimalleolar ankle fracture without posterior lip fracture and ORIF trimalleolar ankle fracture with posterior lip fracture. The elective case designation had greater affiliation with male gender. These findings could have potential use in developing and interpreting quality improvement/performance improvement protocols at individual healthcare delivery centers and in interpretation of other published investigations using the database.

From the article of the same title
Journal of Foot & Ankle Surgery (01/05/22) Meyr, Andrew J.; Sansosti, Laura E.
Share Facebook  LinkedIn  Twitter  | Web Link

Relation of the Sural Nerve and Medial Neurovascular Bundle with the Achilles Tendon in Children with Cerebral Palsy Treated by Percutaneous Achilles Tendon Lengthening
Analysis of the anatomical relations of the sural nerve (SN) and medial neurovascular bundle to Achilles tendon (AT) in children with cerebral palsy was held to classify dangerous levels for iatrogenic injury during percutaneous AT lengthening surgery via magnetic resonance imaging. Included were 30 ankles operated and followed at least one year. The tibial nerve and the posterior tibial artery on the medial side lied more than 5 millimeters away from the tendon at all levels in all patients. Laterally, the first 4 centimeters were relatively safe for the middle lateral cut, while elevated risk of SN damage was spotted in more proximal levels. Six of 30 ankles had radiographically detectable SN injury.

From the article of the same title
Journal of Pediatric Orthopaedics (02/01/22) Erdal, Ozan A.; Gorgun, Baris; Yontar, Necip S.; et al.
Share Facebook  LinkedIn  Twitter  | Web Link

Screws-Only Primary Subtalar Arthrodesis for Calcaneus Fractures
A retrospective study sought to review the patient-centered and radiographic outcomes of open reduction internal fixation (ORIF) with primary subtalar arthrodesis (PSTA) for displaced intraarticular calcaneus fractures (DIACFs) using only screws through a sinus tarsi approach. A total 79 DIACFs in 69 patients received PSTA with a median follow-up of 200 days, and post-operative median time to weightbearing was 57.5 days. Ten fractures were classified as Sanders II, 36 as Sanders III and 32 as Sanders IV. Sixty-eight fractures (86.1 percent) realized fusion on radiographs at a median of 126.5 days, and 39 fractures (57.3 percent) demonstrated radiographic fusion in all three predefined locations. Nine of 14 worker's compensation patients went back to work within the period of observation. Eight complications occurred, with three requiring a secondary operation, while 11 of 79 fractures treated did not have radiographic union.

From the article of the same title
Foot & Ankle International (01/04/2022) Bloomer, Ainsley K.; McKnight, R. Randall; Johnson, Nicholas R.; et al.
Share Facebook  LinkedIn  Twitter  | Web Link

Practice Management


Supreme Court Blocks Biden’s Virus Mandate for Large Employers
The US Supreme Court on Thursday blocked the Biden administration from enforcing a vaccine-or-testing mandate for large employers. In doing so, the court dealt a major blow to a key element of the White House's plan to address the pandemic amid surging cases linked to the Omicron variant. But in a modest victory for US President Joe Biden, the Supreme Court allowed a more limited mandate requiring healthcare workers at facilities receiving federal money to be vaccinated. The vote in the employer mandate case was 6-to-3, with the liberal justices in dissent. The vote in the healthcare case was 5-to-4, with Chief Justice John Roberts and Justice Brett Kavanaugh joining the liberal justices to form a majority. The employer decision undercut one of President Biden's most significant attempts to curb the coronavirus, leaving large companies to navigate a patchwork of state laws and policies instead. In both the employer and health worker cases, the justices explored whether Congress had authorized the executive branch to take sweeping actions to address the healthcare crisis. The unsigned majority opinion in the employer case said a statute on workplace hazards did not justify a mandate that would have impacted more than 80 million workers. But it did leave the door open for more tailored regulations by industry.

From the article of the same title
New York Times (01/14/22) Liptak, Adam
Share Facebook  LinkedIn  Twitter  | Web Link - May Require Paid Subscription

How to Support Team Members: Three Lessons From the Great Resignation
The Great Resignation carries lessons for medical practices that want to prevent employee attrition by making workplace support critical. One lesson is to demonstrate appreciation toward staff, with examples including appreciation luncheons, giving staff Starbucks gift cards or making sure they have time to run errands during work hours. A second approach is to regularly survey or query staff about any stress they are experiencing and possible remedies and following through with solutions when feasible. Telehealth services are in high demand, and practices should find ways to incorporate new technologies and processes when possible. A third lesson involves prioritizing medical professionals' mental health by offering time off when needed, permitting breaks for healthy activities and meals, hosting seminars on stress management and partnering with a mental health benefits provider.

From the article of the same title
Medical Economics (01/12/22) Sheehy, Marlene
Share Facebook  LinkedIn  Twitter  | Web Link

Using Key Performance Indicators
Practices can gain an advantage over the competition by properly utilizing key performance indicators (KPIs), described as "any metric of measurement that illustrates the status or progress of a particular operation or effort." One important KPI category is operational metrics, which include staffing metrics, patient wait time, no-show rate/number of missed appointments and percentage of patients who do not schedule follow-up appointments. Using these KPIs in conjunction with digital tools at the office can save staff time, reduce no-shows and make it easy for patients to book or reschedule appointments. Patient acquisition and retention metrics can be quantified by tracking total year-over-year numbers of patients, new patient appointments, number of monthly return patient appointments, percentage of website visitors who progress to new patient appointments, patient satisfaction scores/rates and rates of patient attrition. A third KPI category is marketing metrics, which can be harnessed to increase and retain patients. KPIs to focus on include search engine rankings/position, social media metrics, website performance, website traffic and patient review volume, frequency and average star rating. After choosing KPIs to track, practices can develop a performance scorecard to record and monitor how they are measuring up to their goals.

From the article of the same title
Physicians Practice (01/12/22) Schneider, Travis
Share Facebook  LinkedIn  Twitter  | Web Link

Health Policy and Reimbursement


Almost 14 Million in US Have Signed Up for ACA Coverage in 2022 So Far, Officials Say
US health officials estimated that nearly 14 million Americans have so far enrolled in medical coverage in 2022 through the Affordable Care Act (ACA) before this week's deadline. The Health and Human Services Department said the current open enrollment period has overtaken 2020 signups by 21 percent, while 4.6 million new enrollees gained coverage through the ACA last year. "Thanks to the American Rescue Plan, more Americans across the country are gaining affordable health coverage than ever before, especially when we most need it during this pandemic," said Health and Human Services Secretary Xavier Becerra. "We will continue to reach out and get people covered until the very last minute of the January 15th final deadline." Centers for Medicare and Medicaid Services Administrator Chiquita Brooks-LaSure observed that "a record-setting number of people [are] gaining health insurance through federal and state marketplace. For 3.8 million people, quality, affordable health insurance coverage is now a reality."

From the article of the same title
UPI (01/10/22) Hughes, Clyde
Share Facebook  LinkedIn  Twitter  | Web Link

HHS Secretary Orders Medicare to 'Reassess' Premium Increase Driven by Alzheimer's Drug
US Secretary of Health and Human Services (HHS) Xavier Becerra has directed the US Centers for Medicare and Medicaid Services (CMS) to "reassess" a proposed premium hike after Biogen halved the price of its expensive new Alzheimer's drug. "With the 50 percent price drop of Aduhelm on January 1, there is a compelling basis for CMS to reexamine the previous recommendation," he declared. Medicare had announced in November a 14.5 percent increase for 2022 in the monthly premium that enrollees must pay, from $148.50 to $170.10, partly to cover the cost of Aduhelm. However, backlash prompted Biogen to slash the drug's $56,000-per-year initial price to $28,200, and Medicare may no longer need to raise as much money via premium increases to cover it. Some experts say evidence was lacking for the Food and Drug Administration to authorize Aduhelm, adding that it is not clear that it is effective. Congress has also been pressuring the Biden administration to ditch the Medicare premium boost for seniors.

From the article of the same title
The Hill (01/10/22) Sullivan, Peter
Share Facebook  LinkedIn  Twitter  | Web Link

Medicine, Drugs and Devices


Senate panel OKs Califf Nomination for FDA Chief
The US Senate Committee on Health, Education, Labor and Pensions on Thursday voted 13-8 to advance the nomination of Robert Califf, MD, a cardiologist, to lead the US Food and Drug Administration to the full Senate. Some Democratic lawmakers voiced concern over Califf's role in addressing the nation's opioid crisis. Four GOP members of the committee, including US Sen. Richard Burr (R-NC), voted in favor of Califf's nomination. Burr, the ranking Republican member, pointed to Califf's "unparalleled experience" and willingness to back medical innovation. The Republican committee members who voted against Califf mostly voiced concerns about abortion policies. For several years, Califf has led clinical trials at the Duke University Medical Center in North Carolina. He most recently oversaw clinical policy and strategy for Verily, the life sciences arm at Google's parent company, Alphabet. During the hearing, Califf stressed the value of existing data — of which large portions are in patients' electronic medical records — to help answer challenging questions about drugs and devices.

From the article of the same title
New York Times (01/13/22) Jewett, Christina
Share Facebook  LinkedIn  Twitter  | Web Link - May Require Paid Subscription

The New Trend in Healthcare: Do-It-Yourself
As accessing care becomes more challenging during the COVID-19 pandemic, industry analysts and physicians say consumers are conducting an increasing number of diagnostic procedures themselves using various devices, home kits and apps. Some healthcare providers warn that obtaining self-care in the absence of professional guidance could cause people to overlook important health problems. However, other providers are recommending that patients turn to DIY tools. Wendy Wright, DNP, a nurse practitioner who owns two clinics in southern New Hampshire, requests patients to monitor their blood pressure and send her electrocardiograms from their smartwatches. She reviews the data on a daily basis and says the real-time data facilitates her ability to make diagnoses and referrals to specialists. For patients with migraines, Wright recommends they use an app named Migraine Buddy, which allows her to access information about headache frequency and duration, food consumed and weather changes. Shantanu Nundy, chief medical officer of digital healthcare firm Accolade Inc., which owns PlushCare, encourages his patients to use apps for weight loss, meditation and getting prescription refills. He wants them to know when they are due for routine tests, such as mammograms and colon-cancer screenings, without having to rely on physicians to tell them. Nundy also guides patients to online sources for finding the best price on prescriptions or ordering do-it-yourself lab tests.

From the article of the same title
Wall Street Journal (01/11/22) Morris, Betsy
Share Facebook  LinkedIn  Twitter  | Web Link - May Require Paid Subscription

Review Finds Too Few Innovative Drugs in Antibiotic Development Pipeline
A review in Antimicrobial Agents and Chemotherapy found that the antibiotic development pipeline has comparatively few clinically differentiated products in late-stage clinical development, in particular against critical, multidrug-resistant pathogens. The review examined all conventional and non-conventional antibacterial drug candidates that were being evaluated in clinical trials as of June 30, 2021. It tallied 76 products, of which 45 are conventional antibacterial agents and 31 non-conventional. Sixty of those candidates (79 percent) are in Phase I (28) or Phase II (32) trials, while 12 are in Phase III trials and four are under regulatory review. Of the 76 candidates, 42 are being developed to address pathogens regarded as critical (26) and high/medium priority (16) by the World Health Organization. Furthermore, 16 products are being developed to treat mycobacterial infections (14 for tuberculosis and 2 for non-tuberculosis mycobacteria) and 15 to treat Clostridioides difficile infections. However, only 18 of the antibacterial agents in development have new pharmacophores, which is one of the components that can determine if an antibacterial candidate belongs to a new class or sub-class of antibiotics; only four have new, overarching modes of action. The review also revealed that 12 new antibacterial products have been approved globally since 2017, but only one (vaborbactam) belongs to a new antibiotic class.

From the article of the same title
CIDRAP News (01/12/2022)
Share Facebook  LinkedIn  Twitter  | Web Link


     

This Week @ ACFAS
Content Reviewers

Caroline R. Kiser, DPM, FACFAS

Elynor Giannin Perez DPM, FACFAS

Britton S. Plemmons, DPM, AACFAS


Contact Us

For more information on ACFAS and This Week @ ACFAS, contact:

American College of
Foot and Ankle Surgeons
8725 W. Higgins Rd.
Suite 555
Chicago, IL 60631
P: (773) 693-9300
F: (773) 693-9304
E: ThisWeek @acfas.org

Visit Us: Friend us on Facebook Follow us on Twitter Link us in on LinkedIn



This Week @ ACFAS is a weekly executive summary of noteworthy articles distributed to ACFAS members. Portions of This Week are derived from a wide variety of news sources. Unless specifically stated otherwise, the content does not necessarily reflect the views of ACFAS and does not imply endorsement of any view, product or service by ACFAS.

Some publication websites may require user registration or subscription before access is granted to the links following the articles. If an article is unavailable online, a link is provided to that publication's homepage.

Copyright © 2022 American College of Foot and Ankle Surgeons

To change your email address, please click here. If you wish to unsubscribe, click here.

News summaries © copyright 2022 Smithbucklin