Today, orthopedists face a rapidly evolving healthcare landscape. Across the U.S., costs increase as the workforce shrinks and practices face significant administrative burdens. These elements create substantial headaches for orthopedists looking to run successful practices. Many turn to consolidation to alleviate some of these challenges—but in the end, consolidation doesn’t always offer practice owners the freedom and flexibility they want.
While overcoming these challenges may seem impossible, it can be done—in fact, independent providers are doing it every day. The key is finding an expert orthopedic practice management partner who provides the tools and expertise to secure your independence.
Partnering with the right orthopedic practice management partner is critical to practice success. You’ll gain the expertise needed to improve operations, ease financial pressures, and decrease administrative burdens—all while securing your independence.
The Current State of Orthopedic Surgery
Increasing Demand for Orthopedic Practices
An aging population, increasing life expectancy, and growing healthcare challenges create the perfect storm for an increase in the demand for orthopedic care.
- Each year, millions of Americans experience an orthopedic injury, and most of these are caused by falls—incidences that will only increase as the population ages.
- By 2030, Americans 65 and older (a demographic requiring more orthopedic care) will account for 21% of the population.
- It’s estimated that by 2040, 50% of American adults will be diagnosed with arthritis.
- After the age of 50, 1 in 5 women will develop osteoporosis.
- Nearly ¾ of American adults are overweight or obese, putting ongoing strain on individual health and American health overall.
Consolidation
With a growing need for specialized healthcare across the U.S., it’s no surprise that orthopedic surgeons are feeling the impacts of consolidation from hospital systems and private equity groups. More and more practices are either being bought up or joining larger groups. For many, this feels like the right choice to make at the time.
- The orthopedic industry is experiencing both horizontal and vertical consolidation across all regions of the U.S.
- The percentage of orthopedic surgeons working in solo practice nearly halved from 13.2% in 2012 to 7.4% in 2020.
- According to the American Academy of Orthopedic Surgeons (AAOS), 48% of surgeons work in a private practice setting, with 36% in a private practice group (half of these groups have ten surgeons or fewer).
Musculoskeletal Companies
Over the past few years, venture-funded musculoskeletal (MSK) companies have also expanded across various markets, focusing on leveraging patient volume and building large-scale practices. However, this model has yielded mixed results, with some states raising concerns about whether these large-scale, volume-driven practices truly benefit patients, leading to challenges and increased scrutiny of their long-term impact on patient care and outcomes.
Outpatient Advancements and Ambulatory Surgery Centers (ASCs)
On the flip side, less invasive outpatient procedures are on the rise, and more full hip and knee replacements are being completed in outpatient centers. This was driven by a change in approved reimbursable procedures that could be completed in ambulatory surgery centers. Total knee arthroplasty (TKA) was added in 2020, and 11 other procedures (including total hip replacement) were added in 2021. Centers for Medicare and Medicaid Services (CMS) made these changes, citing significant advancements in orthopedic procedures. These new technologies are pushing toward a higher volume of outpatient cases with shorter lengths of stay and (hopefully) lower care costs.
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Orthopedic Practice Challenges
Consolidation is especially appealing to independent orthopedic practices (and specialty practices in general) because of the growing number of challenges that arise from the business side of running a practice:
- Financial challenges include decreasing physician conversion factors, declining reimbursement rates, and increasing practice operating costs.
- Increasing administrative burden as surgeons spend 10+ hours per week on paperwork, often dealing with ongoing complications as the number of planned orthopedic surgeries for preventative care grows.
- Supply issues arise as burnout increases and too few people join the medical field—all as demand increases.
The challenges of running an independent orthopedic practice are pushing more specialists toward consolidation—but that’s not your best option.
The Solution: An Expert Orthopedic Practice Management Partner
While private equity and consolidation are often seen as the only paths for specialty providers struggling to manage successful practices, there are other options. For example, practices can partner with a company like TRIARQ Health, for dedicated orthopedic practice management services.
Independent orthopedic practices don’t have to feel cornered into consolidation or private equity investment. By working with an expert orthopedic practice management partner, practices can maintain their independence while gaining the support they need to thrive.
A partner, like TRIARQ Health, will have specialty-specific expertise and tools to assist you across all aspects of your practice. From business operations to streamlined processes and ongoing growth, your orthopedic practice management expert will ensure you secure your practice independence while managing all the challenges and administrative burdens you’re already dealing with. The right orthopedic practice management partner will guide you in the following:
- Technology management, including selecting, managing, and maintaining IT systems
- Financial optimization, such as billing and coding, and keeping up with complex prior authorization processes
- Employee management, like handling the costs of support staff as well as hiring, managing, and training them
- Payer relations, including all the complexities of prior authorization and constantly changing processes
- Regulatory compliance, such as adhering to HIPAA regulations, government directives, and other policies involving business risk
- Practice operations, including streamlined care coordination for strengthened practice operations
- Market dynamics will help you understand where your practice stands compared to similar practices, hospitals, and health systems in your area.
The right orthopedic practice management partner will not only improve practice operations but also advance your practice and strengthen your independence.
TRIARQ: Your Ideal Orthopedic Practice Management Expert
At TRIARQ, our priority is to help you maintain a successful independent practice. We do that by providing comprehensive orthopedic practice management services. We can transform your practice operations and improve business functions so you can focus on what really matters—taking care of patients. We’re here to address your administration challenges while enabling practice growth and improved patient outcomes.
The reality is that in this market, doing what you have always done isn’t quite enough anymore. As healthcare changes, practices must change, and operations must be modified to meet today’s new requirements. This may feel daunting, but as your comprehensive orthopedic practice management partner, we’re here to help.