Value-Based Care in Orthopaedic Surgery: Outcomes, Costing, and Policy Updates.

J Bone Joint Surg Am · Jul 10 2025 · Review

Kleinsmith RM, Puckett HD, Cunningham BP

Department of Orthopaedics, TRIA Orthopaedic Center, Bloomington, Minnesota

Adult Reconstruction

SUMMARY — THE REDUCTIONValue-based care requires measuring outcomes against costs to redirect resources; machine learning advances help identify high-value interventions and exemplary surgeons.
Abstract, as published

➢ Strategic action following the measurement of outcomes in the context of cost allows for the reallocation of resources to value-adding interventions, while eliminating non-value-adding services.➢ Providers and administrators should leverage institutional alignment to advance best-practice principles through integration and utilization of patient-reported outcomes and cost-containment initiatives and engagement in institution-wide value-based care dialogue.➢ Health-care policy and reimbursement structures in the United States are shifting from a fee-for-service model to a value-based care model with policy changes such as the Hospital Price Transparency Regulation by the U.S. Centers for Medicare & Medicaid Services, Comprehensive Care for Joint Replacement, the risk-standardized performance measure for elective total hip arthroplasty and total knee arthroplasty based on patient-reported outcomes, and the Transforming Episode Accountability Model.➢ The incorporation of machine learning technologies presents major potential for refining our understanding of high-value events and identifying exemplary surgeons within the orthopaedic field. The successful incorporation of artificial intelligence models into practice requires investment from and alignment of several partners: health-care administrators, information technology, legal teams, providers, and patients.

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