As more payers push orthopedic bundles, surgeons and health system leaders are being asked to improve outcomes at lower cost, all while navigating siloed workflows, tightening budgets and rising patient expectations. Orthopedic leaders say the biggest challenges lie not in clinical care, but in the operational and cultural shifts required to make value-based models work.
Question: With more payers pushing orthopedic bundles, what’s the toughest part of delivering value-based care in your practice?
Editor’s note: Responses have been lightly edited for clarity and length.
Kevin Bozic, MD. Professor and Chair, Department of Surgery & Perioperative Care, Dell Medical School at the University of Texas (Austin): Delivering high-value care requires measuring patient-reported outcomes and the true costs of care — and integrating that data into routine practice. The biggest challenge is the cultural shift this demands. Clinicians often resist new tools and workflows they view as disruptive, especially when the benefits aren’t immediate. Success depends on showing teams how measuring outcomes and costs ultimately improves patient value and strengthens care delivery.
Mark Vrahas, MD. Professor and Chair, Department of Orthopedics, Cedars-Sinai (Los Angeles): Value-based success depends on reducing waste, improving efficiency and integrating care across the entire patient journey. But healthcare’s siloed structure and misaligned incentives make that integration difficult. Financial pressures add another barrier, as it can be challenging to secure upfront investment in the infrastructure needed to support value-based models, even when the long-term gains are clear.
