Bozic Value-Based Health Care in Orthopaedics

Orthopaedics as a Service Line

16 CHAPTER

Ahmed Siddiqi, DO, MBA • Nicolas S. Piuzzi, MD Ashley E. Chacko, MHA • Wael K. Barsoum, MD, FAAOS

Dr. Siddiqi or an immediate family member has stock or stock options held in AZSolutions, LLC, Monogram Orthopaedics, ROM Tech, and Stabl. Dr. Piuzzi or an immediate fam ily member serves as a paid consultant to or is an employee of Stryker; has received research or institutional support from Osteal Therapeutics, Peptilogics, RegenLab, Signature Orthopaedics, and Zimmer; serves as a board member, owner, officer, or committee member of American Association of Hip and Knee Surgeons, ISCT, and Orthopaedic Research Society. Dr. Barsoum or an immediate family member has received royalties from Stryker; serves as a paid consultant to or is an employee of Cleveland Clinic and Healthcare Outcomes Performance Company (HOPCo); has stock or stock options held in Beyond Limits, Capsico Health, Custom Orthopaedic Solutions, Health XL, PeerWell, PT Genie, and Sight Medical; serves as a board member, owner, officer, or committee member of Florida Board of Medicine. Neither Ashley E. Chacko nor any imme diate family member has received anything of value from or has stock or stock options held in a com mercial company or institution related directly or indirectly to the subject of this chapter. The concept of healthcare service lines strategies was introduced in the late 1980s in an effort to gain market share due to significant interhospital competition. 1 As the driving forces of health care advancement have progressed over time, inter hospital competition has diminished with the introduction of specialty hospitals and ambulatory surgical centers. 2-4 Over the past decade, there has been a renewed focus on establishing streamlined service line management due to an increasing Copyright © 20 Wolters Kluwer, Inc. Unauthorized reproduction of the content is prohibited. 23 INTRODUCTION Orthopaedic surgery as a medical subspecialty has experienced significant prog ress over the past decade, contributing to the advancement of enabling surgical technologies and robotics, the propagation of ambulatory surgery centers, the evolution of the surgeon and vendor company relationship, and the upswing of gain-sharing models and surgeon co-management of growing orthopaedic busi nesses. As the demand of orthopaedics continues to rise, orthopaedic service lines are evolving and transforming delivery of patient care through standardized care pathways while curtailing cost. This is especially relevant during the current cli mate of healthcare reform that has shifted towards value-based care. Orthopaedic surgeons must be conscious of outcomes and resource utilization within their practice because failure to address clinical shortcomings may result in financial implications. This chapter focuses on the process of establishing and building a successful orthopaedic service line. BACKGROUND

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Value-Based Health Care in Orthopaedics