Orthopedics is entering a pivotal period as outpatient migration accelerates, new technologies reshape surgical workflows and musculoskeletal demand surges.
Five forces in particular are slated to influence orthopedic care delivery heading into 2026:
1. Single-specialty centers gain momentum: Orthopedic ASCs are multiplying, with industry leaders noting a clear rise in single-specialty orthopedic centers designed for high efficiency and equipment-intensive procedures such as total joints and spine. This shift is driving new investment, partnerships and competition among ASC operators.
2. Regulatory changes open the door for more orthopedic and spine cases to move outpatient: CMS’ proposal to remove 285 musculoskeletal codes from the inpatient-only list is expanding opportunities for surgeons to shift appropriate orthopedic and spine procedures into ASCs.
This change strengthens provider-patient decision-making, enables safe outpatient management of many revision and spine cases, and continues the migration trend seen when knees and shoulders were removed from the IPO list.
3. Robotics, AI and smart implants redefine orthopedic precision and personalization: Orthopedic surgeons say a new wave of technology is reshaping surgical workflows. Robotics, for instance, has advanced accuracy and alignment, and AI is prompting surgeons to rethink decades-old approaches to joint replacement.
Smart implants and wearable sensors have also given surgeons access to real-time recovery data, enabling early intervention and more personalized care pathways.
4. ASCs recalibrate growth strategies amid staffing pressures and shrinking pools of independent surgeons: Orthopedic ASC leaders say their growth plans hinge on adding new centers, improving efficiency and expanding direct-to-employer partnerships, but staffing and anesthesia shortages prove to be major constraints.
Recruitment struggles compound the problem, with more physicians working for hospital systems. As a result, ASCs must increasingly compete for the remaining independent surgeons, even as rising patient acuity sends more complex cases back to hospitals.
5. Value-based care redetermines medical necessity: Value-based and risk-based payment models are shifting focus to identifying “the right treatment [for] the patient at the right time,” one surgeon told Becker’s.
At Henry Ford Health, for example, surgeons use episodic and condition-based bundles along with patient-reported outcome measures to determine who will genuinely benefit from surgery versus nonoperative care. This approach has reduced unnecessary procedures while preserving appropriate surgical volume, and leaders say objective outcomes data will be essential for any orthopedic group participating in value-based care.
