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  • Deadline Approaches to Adopt Version 5010

    Although the Centers for Medicare and Medicaid Services (CMS) has delayed enforcement of Version 5010 transaction standards used for electronic health care claims until March 31, 2012, the official deadline to adopt the standards is January 1, 2012.

    To help providers prepare for implementation of Version 5010 and ICD 10 code sets, CMS recently released several new resources, including enforcement FAQs, Version 5010 and ICD-10 transition basics fact sheets, a Version 5010 readiness fact sheet, and a timeline widget. Sign up for industry e-mail updates and receive news and information about new resources to help ensure smooth transitions to Version 5010 and ICD-10.

    ACO Podcast Series: Innovation Center Initiatives

    APTA recently released a fifth podcast in a special series on Accountable Care Organizations (ACOs). This latest podcast focuses on the work of the Center for Medicare and Medicaid Innovation (Innovation Center) in the area of integrated models of care, specifically the Advanced Payment Initiative and the Pioneer ACO model.

    The Advance Payment Initiative developed by the Innovation Center is designed for organizations participating as ACOs in the Medicare Shared Savings Program. Through this initiative, selected participants in 2 types of organizations in the Shared Savings Program will receive advance payments that will be recouped from the shared savings they earn as indicated in their agreements with the Centers for Medicare and Medicaid Services (CMS). Under the Advance Payment Initiative, participating ACOs will receive 3 types of payments.

    The Pioneer ACO Model seeks to support experienced organizations in transitioning from a fee- for-service payment structure to a system that is more closely aligned with improved quality of care and outcomes. CMS recently released brief descriptions of the 32 organizations selected to participate in the Pioneer ACO Model.

    A transcript of the prerecorded podcast also is available.

    New Hospital Guidelines Have Significant Implications for PTs

    This article has been temporarily removed. An update will be provided the week of January 2.

    UPDATE: Please see the article titled "New Medicare Conditions of Participation Guidelines for Hospital-based Outpatient Settings" posted January 4 for information on these new guidelines.   

    New in the Literature: McKenzie Method (Spine. 2011;24:1999-2010.)

    In patients with low back pain for more than 6 weeks presenting with centralization or peripheralization of symptoms, the McKenzie method is slightly more effective than manipulation when used adjunctive to information and advice, say authors of an article published in the November issue of Spine

    A total of 350 patients with low back pain (>6 weeks) with centralization or peripheralization of symptoms with or without signs of nerve root involvement were enrolled in this randomized controlled trial. The main outcome was the number of patients with treatment success defined as a reduction of at least 5 points or an absolute score below 5 points on the Roland Morris Questionnaire. Secondary outcomes were reduction in disability and pain, global perceived effect, general health, mental health, lost work time, and use of medical care.

    Both treatment groups showed clinically meaningful improvements in this study. At 2 months follow-up, the McKenzie treatment was superior to manipulation with respect to the number of patients who reported success after treatment (71% and 59%, respectively). The number needed to treat with the McKenzie method was 7. The McKenzie group showed improvement in level of disability compared with the manipulation group reaching a statistical significance at 2 and 12 months follow-up. There also was a significant difference of 13% in the number of patients reporting global perceived effect at end of treatment. None of the other secondary outcomes showed statistically significant differences.

    Foundation-Funded Researcher's Study Featured on Newswires

    Alzheimer Disease biomarkers and a low body mass index (BMI) are linked in the development of the disease, according to a study led by APTA member Eric Vidoni, PT, PhD, and recently published in Neurology. The study was mentioned in the online editions of US News & World Report, CBS News, and CNN Health. Vidoni was the recipient of a 2009 New Investigator Fellowship Training Initiative (NIFTI) postdoctoral research fellowship from the Foundation for Physical Therapy, which provided partial funding for the study.

    For this study, Vidoni and colleagues analyzed cross-sectional data from participants enrolled in the Alzheimer Disease Neuroimaging Initiative (ADNI) with PET imaging using Pittsburgh Compound B (PiB, n = 101) or Cerebrospinal fluid (CSF) analyses (n = 405) for β-amyloid peptide (Aβ) and total tau. They assessed the relationship of CSF biomarkers and global PiB uptake with BMI using linear regression controlling for age and sex. They also assessed BMI differences between participants who were and were not considered biomarker positive. Finally, they assessed BMI change over 2 years in relationship to Alzheimer Disease biomarkers.

    According to their findings, no dementia, mild cognitive impairment (MCI), and Alzheimer Disease groups were not different in age, education, or BMI. In the overall sample, CSF Aβ (β = 0.181), tau (β = −0.179), tau/Aβ ratio (β = −0.180), and global PiB uptake (β = −0.272) were associated with BMI, with markers of increased Alzheimer Disease burden associated with lower BMI. Fewer overweight individuals had biomarker levels indicative of pathophysiology. These relationships were strongest in the MCI and no dementia groups.

    Vidoni’s 2-year Foundation funded NIFTI research fellowship supported work on his project titled "Cardiorespiratory Fitness and Executive Function in Early Alzheimer’s Disease," which was completed at the University of Kansas (KU) Medical Center. He recently received a KL2 Career Development Award, and currently acts as the assistant director of KU’s Alzheimer Disease Center, a designated National Alzheimer Disease Center by the National Institutes of Health, as well as a research assistant professor in the Department of Neurology at the University of Kansas Medical Center.

    Visits to ED for Arm Fractures Expected to Rise With Aging Baby Boomers

    A new study suggests that number of people who go to the emergency department (ED) for a broken arm could rise by nearly a third by 2030, when the youngest baby boomers turn 65, says an article by Reuters

    Researchers analyzed data on 28 million ED visits across the United States in 2008 and found 370,000 cases of humerus fractures. Children ages 5-9 accounted for the highest overall number of humerus breaks, but the arm injuries also spiked among women after age 40 and men after age 60. The researchers report that 38.7 million Americans were 65 or older in 2008, but in 2030, that number will be 71.5 million. In their article, published in Arthritis Care Research, the researchers project 490,000 ED visits for humerus breaks in that year, with much of the increase likely to be among older Americans.

    The highest number of proximal humerus breaks, an injury often associated with falls, was seen in both men and women after age 45. Those rates kept rising until about age 84. Women were more than twice as likely as men to have proximal humerus break, and saw an uptick in the breaks starting after age 40, which the researchers attributed to lost bone density, says Reuters.

    Fractures near the elbow were the second most common upper-arm fracture. Children under age 15 accounted for almost 65% of those.

    Nearly 90% of upper-arm breaks were caused by falls, prompting the authors to call for "[r]igorous safety measures to reduce falls and improved preventive treatments of osteoporosis."

    New Center to Speed Movement of Discoveries From Labs to Patients

    In a move to re-engineer the process of translating scientific discoveries into new drugs, diagnostics, and devices, the National Institutes of Health (NIH) recently established the National Center for Advancing Translational Sciences (NCATS). Working closely with partners in the regulatory, academic, nonprofit, and private sectors, NCATS will strive to identify and overcome hurdles that slow the development of effective treatments and cures.

    To meet the goals of NCATS, NIH is reorganizing a wide range of preclinical and clinical translational science capabilities within NIH into an integrated scientific enterprise with new leadership and a new agenda.

    NCATS will include the following programs:

    • Bridging Interventional Development Gaps, which makes available critical resources needed for the development of new therapeutic agents
    • Clinical and Translational Science Awards, which fund a national consortium of medical research institutions working together to improve the way clinical and translational research is conducted nationwide
    • Cures Acceleration Network, which enables NCATS to fund research in new and innovative ways
    • FDA-NIH Regulatory Science, which is an interagency partnership that aims to accelerate the development and use of better tools, standards, and approaches for developing and evaluating diagnostic and therapeutic products
    • Office of Rare Diseases Research, which coordinates and supports rare diseases research
    • Components of the Molecular Libraries, which is an initiative that provides researchers with access to the large-scale screening capacity necessary to identify compounds that can be used as chemical probes to validate new therapeutic targets
    • Therapeutics for Rare and Neglected Diseases, which is a program to encourage and speed the development of new drugs for rare and neglected diseases

    The formation of NCATS was a recommended by the NIH Scientific Management Review Board in December 2010 to create a new center dedicated to advancing translational science.