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February 23, 2022 ACFAS.org | FootHealthFacts.org | JFAS | FASTRAC | Contact Us

News From ACFAS


ACFAS 2022 is Here!
ACFAS 2022 has taken over Austin to kick off the 80th Annual Scientific Conference! Whether you’re joining us in Austin or following along from home, we’re looking forward to another great week.

We kicked off this year’s meeting today with our lineup of Pre-Conference Workshops and tomorrow it’s officially underway with the first full day of sessions covering more trending topics on the latest in foot and ankle surgery. Tomorrow morning we’ll hear from this year’s keynote speaker Myron Rolle, MD and officially open the meeting with the Premier Connection Opening Event at the Hilton Austin tomorrow evening.

We’re excited to be back together in person for #ACFAS2022 and look forward to seeing everyone. Be a part of the action by following along with us on social media, and if you’re joining us in Austin be sure to share your meeting experience with us.
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Meet Your 2022-2023 ACFAS Board of Directors
Congratulations to new ACFAS President Michael J. Cornelison, DPM, FACFAS; President-Elect Eric A. Barp, DPM, FACFAS; Secretary-Treasurer George T. Liu, DPM, FACFAS; Immediate Past President Thanh Dinh, DPM, FACFAS; Andrew Meyr, DPM, FACFAS; Alan Ng, DPM, FACFAS; and Matt Williams, DPM, FACFAS.

The new officers will officially take office on Friday, February 25 during the ACFAS Honors and Award Ceremony in Austin along with new board members: Amber Shane, DPM, MS, FACFAS, Shane Hollawell, DPM, FACFAS and Alan MacGill, DPM, FACFAS.

We’d like to thank our retiring board members, Scott Nelson, DPM, FACFAS, Christopher Lotufo, DPM, FACFAS and Barry Rosenblum, DPM, FACFAS for their steadfast dedication and service to the College.
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Austin Marathon Success!
ACFAS promoted YOU and the specialty this past weekend in a booth at the Austin Marathon! Runners need foot and ankle surgeons and they proved just that with over 4,000 of them stopping at the ACFAS booth to pick up a reusable free FootHealthFacts.org hot/cold pack, grab infographic literature on keeping their feet healthy for running and to ask questions of our foot and ankle surgeons who manned the booth.

The popular marathon drew over 15,000 runners from every US state as well as from countries from all over the world and showed to be great exposure for the profession. The hot/cold packs were the most-sought after giveaway at the event and attendees were grateful for the information they received on ways to keep their feet and ankles healthy so they can keep running.

The College continues to lay the foundation of promoting the specialty for members and wants to help you build off of the foundation with your own grassroots efforts. Watch for the College’s new Marathon Toolbox debuting this year to help you participate in your own booth at a local marathon or community event. We will have all the tools you need to help you promote your practice and the specialty.
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Join the #ACFAS2022 Conversation
Get the inside scoop and behind the scenes look at ACFAS 2022 whether you’re in Austin or at home—follow all the #ACFAS2022 action on social media.

Follow the College's social media feeds through the conference's mobile app or from your own social media accounts. If you're joining us at the conference, share your Annual Scientific Conference experience with us and your colleagues by using #ACFAS2022 in your posts throughout the week.

We look forward to sharing the #ACFAS2022 experience with you again this year!
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Foot and Ankle Surgery


Plantar Plating in the Modified Lapidus Procedure: Evaluation of Function and Impairment of the Tibialis Anterior Tendon
Researchers investigated whether the modified "Lapidus" procedure (MLP) for arthrodesis of the first tarsometatarsal joint leads to noticeable changes of the tendon or the function of the muscle and clinical postoperative outcome. Twenty-two feet were reviewed, and all patients underwent magnetic resonance imaging (MRI) at an average of 27 months. The scan indicated tendinopathy of the tibialis anterior tendon in 13 feet. The mean total European Foot and Ankle Society score at final follow-up was 17 points while the mean postoperative visual analog scale score was 1.4. Range of motion and force data did not significantly differ from the contralateral side. MRI showed signs of tendinopathy in 59 percent, which does not seem to have a great effect but should to be considered when selecting the desired implant and placement.

From the article of the same title
Journal of Foot & Ankle Surgery (02/14/22) Niehaus, Richard; Hodel, Sandro; Bensler, Susanne; et al.
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Posteromedial Accessory Incision for Posterior Capsular Release and Retractor Placement in a Total Ankle Replacement
The standard approach for performing a total ankle replacement (TAR) is the anterior approach as this offers good direct visualization of the tibiotalar joint. Irrespective of implant system used, most commonly, bone cuts are made in the anterior to posterior direction and may potentially injure the posterior neurovascular structures and tendons running close to the ankle joint. Careful consideration must be taken to ensure these structures are protected.

Researchers introduced a new intraoperative technique of protection for the posteromedial soft tissues and neurovascular structures and included the early results of 60 consecutive patients where the described technique was employed. There were no technique-related complications, or evidence of injury to the PTT, FHL, flexor digitorum longus (FDL), or neurovascular bundles.

From the article of the same title
Foot & Ankle International (02/09/2022) Stoops, T. Kyle; Sanders, Roy W.
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Limited Medial Osteochondral Lesions of the Talus Associated with Chronic Ankle Instability Do Not Impact the Results of Endoscopic Modified Broström Ligament Repair
Chronic lateral ankle instability (CLAI) can be associated with osteochondral lesions of the talus (OLTs), which occur in up to 70 percent of acute ankle sprains and associated fractures. Researchers conducted a retrospective cohort study to compare the two-year clinical results in terms of ankle function and stability. The study included 92 CLAI patients with and without OLTs undergoing an all-inside arthroscopic modified Broström procedure from June 2016 to May 2019.

Of the patients, 32 were placed in the non-lesion group and 60 in the lesion group, according to whether CLAI was associated or not with OLTs. All the osteochondral lesions less than 15 mm in diameter were managed with bone marrow stimulation techniques (arthroscopic microfracture) at the time of the arthroscopic modified Broström procedure. The Visual Analogue Scale (VAS) scores, American Orthopedic Foot and Ankle Society (AOFAS) scores, Karlsson Ankle Function Score (KAFS), Anterior Talar Translation (ATT), Active Joint Position Sense (AJPS), and the rate of return to sports were compared in both groups.

Increase in all the functional scores in both groups was, respectively, recorded 1 year and 2 years after surgery. At the 1-year and 2-year follow-up, there was no significant difference in the VAS, AOFAS, KAFS, ATT, and AJPS scores between the non-lesion and lesion groups. In patients with CLAI who underwent an arthroscopic modified Broström procedure, the presence of limited OLTs (less than 15 mm in diameter), which required arthroscopic microfracture, did not exert any influence on outcome.

From the article of the same title
Journal of Orthopaedic Surgery and Research (02/03/22) Feng, Shi-Ming; Chen, Jie; Ma, Chao; et al.
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Practice Management


Rethinking Software Selection
Peak Plastic Surgery's Devan Griner, MD, writes that independent physicians can enjoy success by implementing software that enables them to run a cohesive and unified practice, and the first order of business when choosing software is to consider the desired scope of functionality. They should first consider the specific patient populations served and their ideal workflow. When assessing telemedicine options, Griner says software should be unified with electronic health records to ensure a seamless workflow. "An all-in-one system that merges telemedicine options with practice management functions, achieves EHR integration and streamlines billing and reporting services is typically the most cost-effective and efficient solution," he advises.

Griner also recommends that practices determine how customizable notes and templates are regarding workflow and patient populations. "A key consideration is [the software's] ability to integrate patient relationship management functionality into daily operations," he notes, adding that "the software you choose will ideally generate automatic reminders for appointments, solicit feedback and share other communications via text message or email.

From the article of the same title
Physicians Practice (02/16/22) Griner, Devan
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The Ransomware Threat: Three Steps to Protect Your Practice
Healthcare practitioners can help protect their business, patients and data by following three steps. Investing in a professional information technology staff will save practices time and money, and inculcate a mindset to prepare for and prevent ransomware attacks rather than treat them as an afterthought. The second step is to upgrade the practice's security infrastructure using advanced cybersecurity solutions that facilitate visibility into basically all application functions during runtime. These tools are engineered to detect and stop any code that is outside the norm. The third and final step is to train all employees to be aware of the threat. This involves staff enabling two-factor authentication on network devices and systems, and following a password management policy that enforces regular updates and strong passwords. A reliable backup and recovery system that is shielded from network access should also be deployed.

From the article of the same title
Medical Economics (02/14/22) Leichter, Willy
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How to Negotiate Physician Payer Contracts
Insurers are increasingly willing to negotiate reimbursement rates for small and mid-size physician groups, and practices should approach this process wisely and with due diligence. Hiring an expert to negotiate rates can be beneficial, but practices should be cognizant that not every company that has negotiated rates is an expert. They should ask to speak to a consulting company's past clients, and provide verifiable references of practices they have worked with of a similar profile. Also worth requesting are examples of actual rate increases they were able to obtain on behalf of clients. Practices that opt to negotiate reimbursement rates on their own should conduct rigorous research, and organize a formal proposal to the insurers outlining why they deserve an increase. They should document whenever they have communication with the insurance company, and have a qualified person review the contract presented.

From the article of the same title
Physicians Practice (02/15/22) Arana, Nathaniel
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Health Policy and Reimbursement


Why Millions on Medicaid Are at Risk of Losing Coverage in the Months Ahead
The Urban Institute estimates that 15 million people younger than 65 could lose their Medicaid benefits once the COVID-19 public health emergency ends. Nearly all of these individuals would be eligible for other insurance options, such as government programs, the Affordable Care Act marketplaces, or coverage through employers. The transition to other health insurance is not automatic, however. At present, a federal mandate stipulates that anyone enrolled in Medicaid cannot lose coverage during the pandemic. When the mandate ends, state Medicaid officials will assess each person’s eligibility, and people could lose their coverage if they earn too much or fail to provide the information their state requires to verify income or residency. State Medicaid agencies often send renewal documents by mail, which can go to the wrong address. The Biden administration is giving states a year to go through the Medicaid renewal process. Advocacy groups say the process will require large-scale outreach efforts.

From the article of the same title
Kaiser Health News (02/14/22) Pradhan, Rachana
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Few Hospitals Complying with Price Transparency Law
Most hospitals are not posting their prices for medical care online despite the passage of a law requiring them to do so. The Semi-Annual Hospital Price Transparency Compliance Report from PatientRightsAdvocate.org shows that only 14.3 percent of 1,000 randomly sampled hospitals are complying with the rule that took effect on Jan. 1, 2021. The report revealed that most pricing files were incomplete, and noncompliant hospitals failed to disclose the different prices for the same services by all insurers and plans as well as cash prices. Just two of the 361 hospitals owned by three of the largest hospital systems were compliant with the rule. In July 2022, meanwhile, the Transparency in Coverage Rule will become law, requiring group health plans and health insurance issuers to publicly disclose negotiated prices for all covered items and services and historical payments, in addition to cost-sharing information upon request to a participant, beneficiary, or enrollee.

From the article of the same title
Medical Economics (02/15/22) Shryock, Todd
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Senate Confirms Califf as FDA Chief in Tight Vote
Robert Califf, whose nomination to head the U.S. Food and Drug Administration (FDA) was far from certain, won Senate confirmation in a narrow vote. Although he previously spent some time in the role under President Obama, his current path was rockier. Republicans were particularly concerned about how the new FDA director would handle the hot-button issue of medical abortions, while some Democrats worried about his future response to the opioid crisis and Califf's close ties to pharmaceutical industry.

In the end, a vote of 50-46 gave him back the title he held in 2016 and gave FDA a permanent leader for the first time in more than a year. Califf will not only have to tackle the topics of abortion drugs and opioids but also address the possibility of a coronavirus vaccine for children younger than age five years and reviews of e-cigarette applications to remain on the market.

From the article of the same title
New York Times (02/15/22) Jewett, Christina; Cochrane, Emily
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Trump-Era Medicare Program Under Increased Scrutiny
Sources said the Biden administration is considering a revamp to a Trump-era Medicare program in view of rising pressure from progressive Democrats. The direct contracting model permits Medicare participation by private companies as part of a comprehensive health department initiative to improve care while limiting government costs. Medical providers get paid more if they keep patients healthier and lower overall costs to Medicare. Liberals like Sen. Elizabeth Warren are warning that President Biden is clearing a way toward privatizing Medicare by keeping the model unchanged. Earlier this month Warren took aim at the model for attracting "corporate vultures hoping to feed on Medicare," which sources said prompted a White House reassessment of the policy. Biden health officials are considering revisions ranging from new limits to termination.

From the article of the same title
Politico (02/16/22) Levy, Rachael; Cancryn, Adam
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Medicine, Drugs and Devices


Certain Specialty Pharmacy Drugs Double in Price at Hospitals, Study Finds
America's Health Insurance Plans (AHIP) estimates that hospitals on average charge double the price for the same drugs sold by specialty pharmacies—an average $7,000 markup—compared to those purchased through specialty pharmacies. AHIP's Sergio Santiviago said while the higher prices do not mean hospitals are "trying to game the system," specialty pharmacies can save money per claim and per dose, allowing insurers to reimburse the physician for the service of administering the drug instead of the cost of the drug itself.

Physician offices typically charge 22 percent higher prices—an average markup of $1,400—for the same drugs as specialty pharmacies, yet many payer plans would be willing not to mandate the use of specialty pharmacies if their contracted provider agrees to match specialty pharmacy prices for the cost of a drug, according to Santiviago. RSM analyst Rich Kes suggested providers generally focus on the profitability across a patient's complete experience rather than on reimbursement for drugs from Medicare or other payers. "What we have noticed is that health systems have focused more attention around their relationships with pharmacies—whether they build their own specialty pharmacy or look to contract with pharmacies for their patients—when thinking about the 340B Program and other things like that," he explained.

From the article of the same title
Modern Healthcare (02/16/22) Devereaux, Mari
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FDA Takes Steps Aimed at Fostering Development of Non-Addictive Alternatives to Opioids for Acute Pain Management
The U.S. Food and Drug Administration has taken new steps aimed at fostering the development of non-addictive alternatives to opioids to manage acute pain and decreasing exposure to opioids and preventing new addiction. The agency issued draft guidance to provide recommendations to companies developing non-opioid analgesics for acute pain lasting up to 30 days, typically in response to some form of tissue injury, such as trauma or surgery.

From the article of the same title
FDA News Release (02/09/22)
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This Week @ ACFAS
Content Reviewers

Caroline R. Kiser, DPM, FACFAS

Elynor Giannin Perez DPM, FACFAS

Britton S. Plemmons, DPM, AACFAS


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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.

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