Remaining Relevant in Musculoskeletal Care – Positioning Your Service Line for Value

As healthcare reform continues to change the provision and payment of care, orthopedic surgeons and providers of musculoskeletal (MSK) care are challenged to find ways to redesign the coordination and delivery of their services.  Healthcare systems, meanwhile, are struggling to develop strategies to keep up with increasing competition from other health systems and physician-owned facilities, including ambulatory surgery centers (ASCs), advanced imaging, physical therapy, and urgent care centers.  So how are organizations positioning the MSK service line to thrive in this changing landscape?  Let’s explore the five components of the value-based enterprise – integrated, scaled, rationalized, informed, and responsive – and apply them to the delivery of MSK services.


Integrated Icon - smallMSK services must span the complete continuum of care – from operative and nonoperative services designed around preventive medicine to acute and post-acute care.  This requires a thoughtful, multidisciplinary approach to care pathways and protocols that are based on clinical conditions such as osteoporosis, back pain, and elderly fractures, and supported by measurable outcomes.


Scaled Icon - smallPrevailing MSK service lines and private physician practices align with strategic partners to secure needed services and enhance market coverage; strategically and efficiently deploy capital for resources; cultivate population health competencies; and achieve economies of scale.  Health systems that have built a strong, successful primary care network that fosters a culture of patient retention will be better able to scale their MSK services to ensure patients are treated within the system, thus ensuring continuity of care.


Rationalized Icon - smallAlong with reducing costs and enhancing efficiencies, leadership of MSK services across a system of care increasingly must consider consolidating or redistributing key programs (e.g., joint replacement) to optimize resources and ensure the provision of high-quality care in the most accessible manner.  Consolidation may not be the right solution for larger, multihospital systems, but leadership should evaluate the delivery system at each hospital to understand variations in quality, outcomes, and cost, with the goal of creating a consistent patient experience across the entire MSK enterprise.


Informed Icon - smallMSK leadership should be well informed about potentially drastic shifts in the payment environment at the local, regional, and national levels.  Further, they need to effectively leverage operational and clinical data to inform the strategic and operational decision-making process relative to their MSK service line.  Organizations that have their finger on the pulse of private orthopedic practices work to engage orthopedic surgeons in the strategic direction of the service line to dissuade them from pursuing independent strategies (e.g., opening an ASC).


Responsive Icon - smallHigh-performing MSK programs will exhibit lean, well-defined, and proactive decision-making structures that decisively drive the organization forward, particularly during times of change and uncertainty.   They will engage their orthopedic surgeons and other MSK providers in the governance of the service line and demonstrate action by executing key strategies.

Does your organization’s MSK service line exhibit the characteristics of a value-based enterprise?  If not, it’s time to get your orthopedic surgeons involved and evaluate the fundamental attributes of your services to ensure the foundation is established for successful execution of key strategies and ideas.

This entry was posted in Healthcare Reform, Orthopedics/Musculoskeletal, Service Line Strategy and tagged , , , , by Todd Godfrey. Bookmark the permalink.

About Todd Godfrey

With nearly 15 years of healthcare experience, Todd has assisted numerous clients with issues pertaining to the physician enterprise, including serving as the interim executive director of a large, multispecialty medical group. Todd's ability to build working, trusted relationships with both senior hospital leadership and physicians contributes to his successful facilitation of hospital/physician alignment transactions. In addition, he is able to gain an in-depth understanding of operational and performance issues and develop detailed financial turnaround implementation plans for clients. He has successfully designed physician compensation methodologies, as well as developed and implemented orthopedic service lines. Prior to joining ECG, Todd gained extensive experience in physician practice operations, performance improvement, and project management through his prior roles at both Boston Medical Center and Brigham and Women’s Hospital. Todd graduated from Boston University School of Management with a master of business administration degree in health sector management. He also holds a bachelor of science degree in biology from Eckerd College in St. Petersburg, Florida.

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s