Board of Councilors 2015 AAOS National Orthopaedic Leadership
Conference (NOLC) Report
Greetings,
Drs Thomas, Smith, and Blasier joined me from Arkansas at recent NOLC. We visited with our
House Members and Senators. We also attended symposia and were able to give input into
committees and issues. This is BOC report.
Perhaps the major issue facing orthopedic surgeons in 2015 is the challenge of adapting to the
rapidly changing health care environment which includes: the transition of fee –for-service to
value-based reimbursement and bundled payments, implementation of the Affordable Care Act
(Obamacare), increasing capital costs, lower reimbursements and increased data reporting
requirements. The AAOS is responding to these pressures by developing programs to enhance
Advocacy, Communication, and Practice Management.
1. We are our patients’ best advocates, but by the same token, they are our best advocates.
There is a major effort being made to educate patients concerning advocacy issues.
a. AAOS TV was developed for Academy member use in waiting rooms as a vehicle to
help educate patients about bone and joint health issues, and includes segments
about the importance of becoming a patient advocate. Members interested in AAOS
TV should email media@aaos.org.
b. The AAOS has become more influential in the US Congress due to the generosity of
those contributing to the Orthopedic PAC. However, patients and their stories still
seem to resonate well. If you have a patient who you think has a compelling story to
tell, please contact me and I will pass the information on to Academy staff
c. Patients that visit your website need to know about a national campaign called A
Nation in Motion. With more than 700 patient stories, studies that highlight the
value of orthopaedic care and orthopaedic surgeon-authored blog posts, this
multimedia campaign helps illustrate why orthopaedics is such a benefit to society.
We get people back to work, back to life and to doing the things they love. Please
provide a link to A Nation in Motion (www.anationinmotion.org) from your practice
website. . Encourage visitors from your site to submit stories on A Nation in Motion.
Your website also should be linked to www.orthoinfo.org to provide your patients
accurate clinical information about their orthopedic conditions.
2. The Political Action Committee of the American Association of Orthopaedic Surgeons
(Orthopaedic PAC) is the only national political action committee in Washington, D.C., that
solely represents orthopaedic surgeons before Congress. While there is considerable
diversity of expertise in orthopaedics, there is enough commonality to remain united in our
advocacy efforts so that we can have enough clout to have an influence on the national and
state legislative processes. The legislation to eliminate the Sustainable Growth Rate (SGR)
was passed this year largely due to the efforts of the AAOS PAC.
The Orthopaedic PAC held an evening fundraising event which raised a record $58,150.
More than 130 AAOS Fellows gathered for the event. Members of the PAC’s donor level, the
Capitol Club, joined other PAC donors who purchased tickets to attend the event or
bundled contributions from colleagues back home. Representatives Ryan Costello (R-PA),
Bill Flores (R-TX), Dutch Ruppersberger (D-MD), Mark Takano (D-CA), Mike Fitzpatrick (R-
PA), Evan Jenkins (R-WV), Derek Kilmer (D-WA), Pete Sessions (R-TX), and Bill Johnson (ROH) interacted with the PAC contributor attendees.
Each of us needs to contribute to the AAOS PAC to continue to effect change. Visit
www.aaos.org/pac to donate and learn more.
3. There is a gradual shift to value-based reimbursement from traditional fee-for-service.
Value is defined as a ratio between quality and cost. In other words, the higher the quality
and the lower the cost, the greater the value.
a. It is crucial that orthopaedic surgeons retain a leadership position in defining
quality of orthopaedic care. Orthopaedic surgeons are the most qualified
professionals to develop and evaluate quality of care measures for patients with
musculoskeletal conditions. Though the Performance Measures Committee, the
AAOS along with the appropriate specialty society is leading the development of
orthopaedic quality measures. These are the tools that will be used to judge your
performance in the value-based reimbursement models of the not so distant future.
This is a link to the initial effort concerning osteoarthritis of the knee:
http://www.aaos.org/research/evidence/ebpc_library.asp.
b. Improving the quality of care is a key to success in the future market. Clinical
Practice Guidelines (CPGs) are valuable tools that will allow you to advance the
physician-patient communications process and enhance the diagnosis and
treatment of musculoskeletal conditions. These will be updated every 5 years and
an app is being developed that will make CPGs searchable, interactive, and easy-touse. Go to www.orthoguidelines.org to see an early web version of this app.
4. Physician-Hospital alignment has become more common in recent years in an effort to
increase value. These alignments include employment models, co-management of
orthopedic service lines such as orthopedic trauma or total joint arthroplasty, or other
arrangements. The Economics Committee of the BOC is investigating the possibility of
producing a primer to enlighten membership concerning these options.
5. The AAOS launched the Professional Compliance Program at the 2004 Annual Meeting in
response to the membership's desire to address the issue of inappropriate or fraudulent
expert witness testimony. This program remains popular among the membership of the
AAOS; more than $2 million has been spent to maintain this program.
6. The State Legislative and Regulatory Issues Committee of the BOC continues to deal with
issues including tort reform, scope of practice issues involving podiatrists and physical
therapist, restriction of ancillary services and advanced imaging.
7. It can be argued that the most important committee of the AAOS is the Board of Councilors,
but the BOC will only be strong if the state societies are strong. The State Societies
Committee continues to study and respond to grant requests by the individual state
orthopedic societies.
The BOC and the BOS conducted their business through nine (9) committee meetings, one (1)
roundtable, and two (2) business meetings. In addition to topics specific to their groups, we
collectively discussed and acted upon the following five (5) advisory opinions during an open
hearing and a joint business meeting:
1. Request to Change the Maintenance of Certification (MOC) Process for the American Board of
Orthopaedic Surgery (ABOS);
2.
3.
4.
5.
Use of an Evidence-Based Process to Assess the Recertification and MOC Process of the ABOS;
Explore Alternate Accreditation for Orthopaedic Fellowships;
Equity in Graduate Medical Education (GME) Funding; and
AAOS Recommendation on Mandatory Radiation Safety Awareness Training for Orthopaedic
Surgeons.
The BOC and the BOS will forward the five (5) advisory opinions to the AAOS BOD for
consideration and action for the BOD’s June 2015 meeting.
If you have questions about any of these issues or programs, or if you would like an issue brought
forward to the BOC, please contact me. The BOC will meet again in October 2015.
Respectfully submitted,
Jeff Angel
jangel@mpoc.cc