Bozic Value-Based Health Care in Orthopaedics

Chapter 16: Orthopaedics as a Service Line

Hip/Knee Osteoarthritis Care Pathways Frequency of visits/touchpoints by treatment pathway

Nonsurgical

Visits/touchpoints

Surgical

Mild OA

Mod OA

Severe OA

# 1 1 0 0.5 7 0 1 4 1 1.5

% 40% 100% 0%

# 1 1 1 1.5 9 0 2 4 2 1.5

% 40% 100% 0%

# 1 1 0 2.5 15 0 3 4 3 1.5

% 40% 100% 0% 100% 75% 0%

# 1 1 1 2 15

% 40%

Prework lnitial Clinic Visit Surgical Experience Follow-up Visit Home Rehab Outpatient Rehab Care Coordination Smoking Cessation Behavioral Health Nutrition Counseling

100% 100% 100% 100% 100%

20% 25% 0% 20% 10% 20% 40%

70% 50% 0% 25% 10% 25% 40%

8 2 4 2 1.5

30% 10% 30% 40%

30% 10% 30% 40%

*Mod = moderate, OA = osteoarthritis

FIGURE 2 Key elements of an orthopaedic service line.

surgeons to help align them with the health care system’s service line mission statement and core values. By directing the focus toward optimizing patient care and improving outcomes, health care systems can show clinicians who are part of hospitals that are acquired that a teamwork approach is of utmost importance. Prior to implementing and expecting change within hospitals that have been merged with larger systems, it is critical for administrators to listen to surgeons’ concerns and consider how a larger health system can help improve the surgeon and patient experience. Furthermore, creating gainsharing programs that finan cially reward high quality of patient care can also incentivize surgeons toward adoption of streamlined service line care pathways. BUILDING A SERVICE LINE Surgeon Champion Building a service line starts with identifying a surgeon champion who will help drive programmatic change and leadership both macroscopically and microscop ically within the healthcare organization. A few fundamental characteristics of a surgeon champion include an individual who places the program above indi vidual needs and personal gains, someone who is motivated to optimize surgical volume and improve efficiency, an individual who is a team player with admin istrations, hospital staff, and other physicians, and a person who is supported by other orthopaedic surgeons to represent common interests and ideals. Identifying qualified surgeon champions is essential to improving patient outcomes, lowering complications and total cost of care, and enhancing overall patient and clinician experience and satisfaction. 16 A comprehensive list of surgeon champion charac teristics is presented in Table 1 .

Copyright © 20 Wolters Kluwer, Inc. Unauthorized reproduction of the content is prohibited. 23

266

© 2025 AAOS

Value-Based Health Care in Orthopaedics