Bozic Value-Based Health Care in Orthopaedics


The challenges facing the US healthcare system are considerable. Costs continue to climb at unsustainable rates, access remains challenging for many, and quality metrics continue to lag relative to our global counterparts. At the core of these challenges is a transactional infrastructure that rewards volume of care delivered without emphasis on health outcomes nor on improving access to high-value care. The result is a system that is simultaneously overutilized, underutilized, and inap propriately utilized. Unsurprisingly, due to these and other issues, health care has been thrust into the public and political spotlight. The need for transformation of the US healthcare system has never been more pressing. Such improvements require complete align ment across all stakeholders – clinician, patient, payer – which is in stark contrast to the status quo. Currently, the transactional nature of the fee-for-service system places excessive emphasis on specialty care utilization, which directly results in increased costs without commensurate improvements in health outcomes. In con trast, a value-based health care delivery and payment system aligns the incentives of all stakeholders, including payers, clinicians, and most importantly patients, by prioritizing health over care, and facilitating competition across health care pro viders based on health outcomes and cost. It is with this context in mind that we decided to create a resource for ortho paedic surgeons who are navigating the transition to value-based health care. Even though the focus of this text is on musculoskeletal care, we believe that the underlying principles can be applied to all aspects of modern health care. We are especially grateful to our team of contributing authors, whose deep expertise in value-based health care we have leaned on heavily. We hope you will enjoy read ing and synthesizing the lessons contained herein as much as we did as we assem bled the textbook, and we wish you great success on your journey to value.

Eric C. Makhni, MD, MBA, FAAOS Benedict U. Nwachukwu, MD, MBA Kevin J. Bozic, MD, MBA, FAAOS Copyright © 20 Wolters Kluwer, Inc. Unauthorized reproduction of the content is prohibited. 23


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Value-Based Health Care in Orthopaedics

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