Bozic Value-Based Health Care in Orthopaedics

Chapter 16: Orthopaedics as a Service Line

Identification of contributions of various personnel involved in the service line along with physician leaders among the health care providers enables greater alignment of goals and further allows clinicians to serve distinct leadership roles. Leaders from various specialties involved in orthopaedic patient care delivery, including anesthesiology, emergency medicine, internal medicine, physical ther apy, and case management necessitate key involvement in service line implemen tation. The multidisciplinary integration and alignment encourages physician advocacy while maintaining transparency during program inception and through changes during development. 14 Different subcommittees are often necessary to focus on different aspects of optimizing orthopaedic care both clinically and finan cially. A close working relationship is important in establishing a successful ser vice line. 13 Key stakeholders in and key elements of an orthopaedic service line are depicted in Figures 1 and 2 , respectively. HOW TO ALIGN ORTHOPAEDIC SURGEONS Hospital merger and acquisitions (M&A) have substantially increased over the past decade, with healthcare systems aiming to create large corporations that opti mize strategic and financial value. 15 The primary drivers of M&A include achiev ing economies of scale and decreasing cost while improving outcomes through increased volume. 15 Hospitals and physicians who perform procedures at hos pitals that are newly acquired by larger health systems may often struggle with changes that transpire with M&A. Cost containment and streamlining patient care strategies can sometimes harbor resistance among clinicians and administrators. After M&A, it is especially critical to establish strong working relationships with

Surgeon Champion

Administrator Champion

Clinical Service Line Director

Non-Clinical Service Line Director

Sports Coordinator

Spine Coordinator

Business Development

Joint Replacement Coordinator Copyright © 20 Wolters Kluwer, Inc. Unauthorized reproduction of the content is prohibited. 23 Hand & Upper Extremity Coordinator Oncology Coordinator Trauma Coordinator Marketing Innovative Technologies

Foot & Ankle Coordinator

FIGURE 1 Key stakeholders in an orthopaedic service line with the primary focus on improving quality of care for patients.

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Value-Based Health Care in Orthopaedics