With everything from inflating drug prices to mega-mergers to implications of the Affordable Care Act, it's hard to predict where the industry is headed. More specifically, how will these changes impact orthopedics? At Becker's 14th annual Spine, Orthopedic & Pain Management-Driven ASC Conference, four experts in the field weighed in on the future of this specialty.
"We're right in the transition zone," said Christopher Bono, MD, chief of orthopedic spine service at Boston-based Brigham and Women's Hospital. The heart of that transition zone is the movement from volume-based care to value-based care. "What it's going to do to the orthopedic field is that we'll have to look at the cost of every single decision we make."
But before any changes can be made, the industry must consider how to measure outcomes of value-based payments. "That's what physicians are struggling with," said Nikhil Verma, MD, associate professor at Chicago-based Rush University Medical Center and orthopedic surgeon at Midwest Orthopaedics at Rush. "That's the issue that remains unsolved, and we probably won't be successful in value-based care until we solve it." And solving it isn't an easy task. It will take patient buy-in, as well as determining which data should be collected and ensuring it's clean data.
On top of that, data and technology play an extremely important role in the transition process. John Devine, PhD, medical business unit director at Invibio Biomaterial Solutions, believes their role — specifically as it relates to medical devices — can be seen in two ways. "The medical device industry is changing, and we can see that as a threat or an opportunity," he said.
But Patrick Toy, MD, an outpatient total joint replacement surgeon at Memphis, Tenn.-based Campbell Clinic Orthopaedics, believes the volume to value transition hasn't helped technological advancements. "The ACA and the strive for value-based care have really stifled technology," he said.
Regardless of how it's impacted by technology, all four panelists agreed that the field of orthopedics will rely on the volume-to-value transition as the years go on. "We will be continually asking ourselves, 'Do we need it?' and 'Does it improve outcomes?'" Dr. Bono concluded.