August 07, 2020
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AAOS, AAHKS issue statements on CMS proposal to reduce orthopedic surgical services

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The American Academy of Orthopaedic Surgeons and the American Association of Hip and Knee Surgeons have issued statements in response to a proposal by CMS to reduce the value of and access to orthopedic care, according to a press release.

CMS proposed the policy change in its Calendar Year 2021 Medicare Physician Fee Schedule. The rule would reduce all orthopedic surgical services by approximately 5%, with an additional 5.4% cut on work relative value units for hip and knee arthroplasty procedures, according to the release.

“The AAOS is extremely disappointed in CMS’ decision to disregard our petitioning, many discussions and data presented against these cuts. Devaluing the time and effort that orthopedic surgeons spend prioritizing value-based care communicates a larger plan by the agency to gradually reduce the value of these procedures. Not to mention the fact that our surgeons have the highest participation rates across medical subspecialties in alternative payment models, where they work to optimize care and improve patient outcomes all while reducing costs,” Joseph A. Bosco III, MD, FAAOS, AAOS president, wrote in the statement.

 Joseph A. Bosco III
Joseph A. Bosco III

“Worsening the financial strain on these practices, at a time when they have been disproportionately affected by COVID-19 federal guidelines to delay care, will have a severe and lasting impact on American seniors’ access to these life-improving surgeries. According to an AAOS survey conducted earlier this year, 34% of patients had postponed surgeries by more than 3 months in response to the COVID-19 crisis,” he wrote. “The AAOS urges CMS to reconsider the significant preoperative work that is required to make value-based care both cost-effective and high quality, and to refrain from finalizing both of these punitive cuts on the value of orthopedic care,” Bosco added.

AAHKS had a similar response to the proposed cuts in its press release.

C. Lowry Barnes
C. Lowry Barnes

“If these Medicare cuts are finalized, it sends a strong signal: when providers in the vanguard of value-based care begin to achieve some efficiencies in the delivery of care, CMS will use those positive developments as a justification to cut Medicare fee-for-service reimbursement regardless of the extra work that goes into achieving these outcomes,” C. Lowry Barnes, MD, AAHKS president, said in the release.

James I. Huddleston III
James I. Huddleston III

“AAHKS is deeply disappointed that the AMA [Relative Value Scale Update Committee] RUC and CMS, despite our extensive advocacy efforts over the last 21 months, chose not to give us credit for the pre-optimization work that they acknowledged is being done by our surgeons,” James I. Huddleston III, MD, AAHKS advocacy committee chair, said in the release. “We will continue to work with them to facilitate a mechanism by which this critically important work can be incorporated into their methodologies,” he added.

References:

https://www.aaos.org/aaos-home/newsroom/press-releases/aaos-alarmed-by-cms-proposal/

http://www.aahks.org/aahks-responds-to-cms-proposed-cuts-to-total-joint-arthroplasty/