As healthcare costs rise and reimbursements lag behind, OrthoMidwest is doubling down on data-driven growth, Brian Cole, MD, said.
OrthoMidwest was formed in 2023 and is an aggregation between Chicago-based Midwest Orthopaedics at Rush and Rockford-based OrthoIllinois. And in 2024 the aggregation added Peora, Ill.-based OSF Health.
Dr. Cole, managing partner at Midwest Orthopaedics at Rush, spoke with Becker’s about his top priorities with OrthoMidwest and the healthcare trends orthopedic surgeons should follow in 2026.
Note: This conversation was lightly edited for clarity.
Question: How are you thinking about growth with OrthoMidwest?
Dr. Brian Cole: It’s now one of the largest regional groups after our aggregation in 2023. We’re now growing our footprint with increased aggregation efforts. We still are living in an industry where we’re faced with all the economic challenges such as increasing costs of doing business, cost of living, inflation and so forth. The challenge we have is that pricing and insurance reimbursement usually either stays the same or goes the opposite direction relative to the cost of business, which continues to increase on a yearly basis. With Medicare cuts, Medicaid cuts and CMS changes on an annual basis, we’re still seeing headwinds related to reimbursement that are not tracking with the increased cost of practicing medicine.
Patient access is also still a challenge, and what’s happening is essentially physician practices are starting to underwrite the process because we often don’t have the ability to navigate the payer environment. It often comes back to data in terms of quality and the impact that quality has on patient outcomes and preventing complications and reoperations. The hope is that the data will resonate with payers as a value proposition that is not just a better outcome, but leads to improved economics as it relates to delivering care.
We’re going to improve our ability on the outcomes data front, and that helps clinicians be better. In other words, understanding what their outcomes are, what their decision making is, and our focus has really been on providing quality care. Now we have the ability to actually measure what quality is, and we’re hopeful that it will resonate because it’ll lead to more cost effective care as well. The net benefit is that it creates an ecosystem that is supportive of delivering healthcare and maintaining access. Being bigger is not always better, but being bigger and putting in infrastructure that involves more granular data is going to be our focus in the next year to have a more fertile dialogue on the payer side that will also improve the quality of care.
Q: What other healthcare trends will you be following into 2026?
BC: The thing to focus on is continued consolidation. Consolidation is in many ways, one of the only ways that we can survive the economic trends that we’re seeing. There’s just going to be an increased focus on sharing data, and AI can be used to help make us better.
I really believe that in this coming year, the things you’re going to see are probably continued consolidation. We’ll probably see some continued shake out, at least in the orthopedic space, as far as the impact that private equity had on consolidation. I’m not sure that has been all good, and we’re still trying to figure our way to what the ultimate outcome is going to be after a number of recent transactions. I think we’ll start to see the results of those.
Something we’ll have to sort of pay attention to on the ASC side, to maintain a sort of private, independent practice, it really does require physicians to participate in the entire patient journey. That is what’s most likely to maintain quality. It’s most likely to keep all the data in a place that can be analyzed, looking at all the variables that relate to patient care. It’s not just a surgical experience, it’s the resources that are dedicated to maybe prevent surgery. How long should those resources be allocated for? What do you do postoperatively? What are the most efficient pathways to get a patient safely back to achieve their goals? All that stuff requires access to the patient journey. So that’s sort of an element of consolidation, but it’s also part of how I think practices will sort of maintain themselves. Those are the things we’ll probably see play out in 2026 in a continued way. It’s already starting.
