Unlocking Success: Implementing Orthopedic Value-Based Care

In the evolving healthcare landscape, orthopedic value-based care is emerging as a transformative approach for independent practices seeking to enhance patient outcomes while optimizing operational efficiency. This model shifts the focus from the volume of services provided to the quality and value of care delivered, offering substantial benefits to both patients and practitioners. By embracing orthopedic value-based care, surgeons can not only improve clinical outcomes but also achieve financial sustainability through improved patient satisfaction and reduced costs. 

Orthopedic value-based care models empower you to stay ahead in an increasingly competitive market. 

Value-Based Care Overview

Value-based care focuses on reducing healthcare costs and improving the quality of care by rewarding providers for patient outcomes. This means practices must be set up to properly track and report on critical metrics, as the total revenue depends on these outcomes rather than the number of treatments. Value-based care focuses on five key goals:

1. Provide the best patient experience.
2. Advance health equity.
3. Improve patients’ health outcomes.
4. Deliver health care services at a reasonable cost.
5. Support the well-being of the healthcare workforce.

Participation in value-based care models has increased by 25% between 2023 and 2024. 

Understanding Orthopedic Value-Based Care

Benefits

Orthopedic value-based care ultimately rewards providers for improving patient outcomes. This provides numerous practice benefits:

• Improved patient outcomes and satisfaction
• Reduced administrative and financial burdens by streamlining reimbursement processes and receiving payment faster
• Optimized practice operations by being able to see more patients who drive increased revenue instead of working to increase the number of services provided under traditional models
• Cost reduction as practices focus on preventative care 

As healthcare evolves, orthopedic value-based care contracts that hold providers accountable for quality and cost control will become more common. 

Challenges

While there are numerous benefits to implementing orthopedic value-based care models, there are also some challenges. 

First, there can be a misalignment around defining “value.” At the most basic level, that means giving surgery to people who need it but not operating on people who don’t. If surgery is completed, it must be the right surgery at the right time, but that doesn’t always lead to immediate cost savings. However, sometimes it’s easy to forget that value is not just dollars but also applies to the actual care that is provided. 

Another challenge for orthopedic value-based care is measuring outcomes accurately and succinctly. In orthopedic surgery, practices need to measure not just their goal outcomes but also the things patients care about, like how well they are walking or if they are pain-free. Each patient's goals can differ, and there is not always an infrastructure to capture this data. Ultimately, administrative claims data is used to track these outcomes, but that may not be the best way to do it (especially since patient feedback may not be included). 

The biggest challenge in implementing these types of reimbursement programs is data transparency. It’s all based on metrics, but making the investment in practice tools and operations to build an infrastructure to capture and report on those metrics can be limiting, especially for smaller practices. 

Implementing Orthopedic Value-Based Care with an Expert Partner

Implementing orthopedic value-based care programs is not easy, but you don’t have to do it alone. 

At TRIARQ, we help practices optimize practice operations and build infrastructures to capture the metrics that matter and build out these essential value-based care programs. While implementing changing reimbursement models can be complicated, we can handle it all for you so you can continue to focus on your patients. 

We take a strategic approach and combine our specialty-specific expertise with advanced operational and financial tools to build a reporting system that meets the needs of your orthopedic value-based care contract requirements. This provides you with the insights to:

• Improve patient outcomes
• Design care pathways
• Improve care coordination
• Understand the patient experience
• Plan and deliver care based on evidence of what works best for each patient
• Monitor quality of care
• Reduce costs by eliminating waste and inefficiencies 

Our successful implementation of specialty-specific value-based care programs is the ideal model for future healthcare delivery—providing the basis for ongoing innovation and practice improvement.

Ready to Build Your Orthopedic Value-Based Care Program?

Moving toward value-based care in a meaningful way can seem overwhelmingly complicated. Luckily, there’s a single simple first step in every process. We start with a practice assessment that provides a clear roadmap for optimizing your practice's operations, understanding the competitive market, and identifying growth opportunities, such as value-based care models.