3 trends one orthopedic CEO is watching in 2024


From ongoing financial challenges to reimbursement pressures, Tallahassee (Fla.) Orthopedic Clinic CEO Michael Boblitz told Becker's three major trends he is keeping an eye on in 2024: 

Mr. Michael Boblitz: Trend 1: As hospitals continue to realize headwinds with ongoing financial challenges, their ability to offer orthopedic physicians with competitive compensation packages is fading fast. Hospitals offering high salary compensation with production have a short life, as there are only so many patients a physician can see in a day. While the hospital margins continue to erode, decisions are forced to drive down the compensation production formula — or just outsource the practice altogether to large orthopedic groups with scale such as TOC. The TOC model is built on 50 years of success that offers physician ownership in all ancillary and surgery center revenue streams, as well as other income sources such as real estate, co-management agreements and public-private academic models that accelerate research and education. So, when a physician has matured his or her practice, the compensation still rises via the many diversified revenue streams. Hospitals do not offer these other income sources.

Trend 2: The reimbursement pressures on professional fees requires the increased use of advanced practice professionals. TOC has been ahead of this curve for some time with APPs now accounting for the majority of clinic visits. Our historical challenge is finding orthopedic subspecialty-trained APPs. It takes a very long time to train someone lacking subspecialty orthopedic experience, as we never allow an APP to provide direct patient care until they are fully ingrained in our business. So, we are investing in our new physician assistant fellowship program to accelerate the training required for subspecialty orthopedic care. Our new 14-month PA fellowship program is one of an only few in the entire U.S. and will help grow this much-needed workforce. We will start with two fellows this year and quickly expand to five per year — and aim to hire as many as possible.

Trend 3: New co-purchaser models that sit between the employer and the payer with the aim to aggressively steer patients into lower cost "centers of excellence" are growing quickly and require a thoughtful strategy. These new co-arrangements offer beneficiaries with cash incentives and travel costs to utilize these narrow network centers, such as orthopedics, that are often out of market. These new co-models are aimed specifically at high-cost elective surgeries such as spine and joint replacements. TOC is blessed to have the strength and quality to be considered for these center of excellence models that includes our full range of ancillary services and ASCs.

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