How a Colorado orthopedic practice helps make care accessible

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Considering site of care and using constructive payment plans are ways patients without insurance are able to get care at Denver-based Orthopedic Centers of Colorado, orthopedic surgeon and Chief Medical Officer Brian Larkin, MD, said.

Dr. Larkin shared details of these approaches with Becker's in a May 28 email.

Editor's note: This response was lightly edited for clarity and length.

Question: What strategies are you using to help make care accessible to those without insurance?

Dr. Brian Larkin: A key consideration for all orthopedic providers is being sensitive to the costs that exist in healthcare. This is particularly sensitive when patient’s need or seek care without medical insurance.  

One of the key levers that orthopedic surgeons can use to help contain costs is being cognizant of the site of service where we deliver care. We are strongly invested in the transition to performing orthopedic and spine cases in ambulatory surgery centers when able. This requires a commitment from the surgeon to having consistent, safe protocols to deliver care in these facilities. As we continue to migrate larger spine and total joint cases to ASCs, these savings can be substantial. By doing this, we have the opportunity to decrease overall costs that the patient can be responsible for.

In spine surgery, being aware of the type and amount of instrumentation that is required for procedures is another lever that orthopedic surgeons can help affect. If a patient can undergo nerve decompression without instrumentation, this has the potential to decrease total cost. Clearly, we need to make sure that this cost savings is in the best interest of the patient’s condition. Beyond this, being actively engaged with the payer contracting in the ASCs allows us to help shape the cost discussion. Implant costs can be quite large and by being involved in the process on the front end, we can decrease costs. This often does not happen as often at the hospital level with direct surgeon input, thus highlighting another way where orthopedic surgeons can help contain costs by partnering with ambulatory surgery centers.

Beyond the ways we try to bend the cost curve on a consistent basis, we do also offer constructive payment plans to patients without insurance. This means having a discussion with the patient about what costs can be expected and how we can meet patient expectations and needs. This happens on a regular basis, and as costs continue to increase across healthcare, it is something all key stakeholders need to be actively involved in.

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