Written by Scott Becker and Lindsey Dunn
This article outlines 10 key trends that are impacting orthopedic practices. These trends affect orthopedic practices directly, as well as hospitals and surgery centers that work with orthopedic surgeons.
Orthopedic practices are highly concerned with reimbursement trends, maintaining access to patients and competition from hospitals.
1. Patient deductibles on the rise. Since 2009, high-deductible plans have tripled. Now more than 26 percent of employers have HDHPs, according to PwC’s 2014 Touchstone survey of large employers. The increasing use of high deductible plans by employers and the growth of insurance sold through the healthcare exchanges (exchange-based plans often include high deductibles) means patients increasingly are responsible for a larger share of their healthcare costs. As a result, orthopedic providers will be forced to collect more and more of their revenues from patients directly — who are even more notorious for difficulty in paying than insurers.
Additionally, as their out-of-pocket responsibilities rise, patients become more attentive and careful of their healthcare spending, which can result in delaying healthcare procedures, particularly elective procedures like orthopedic cases that can be delayed without major health consequences. Increasing patient responsibility is also expected to lead to price shopping. If comparison shopping continues to gain traction, practices with transparent pricing information will be best poised for success.
Overall, the increase in HDHPs and health exchanges has a substantial impact on reimbursement per patient and the numbers of procedures performed by orthopedic surgeons.
