Des Plaines-based Illinois Bone & Joint Institute is doubling down on independence and selective consolidation to navigate staffing, reimbursement and regulatory pressures in orthopedics, CEO Andre Blom told Becker’s.
The group, which grew by about 50% through consolidation in 2020, has resisted alignment with health systems or private equity, instead focusing on autonomy and scalability.
IBJI’s philosophy centers on preserving physician autonomy, Mr. Blom said. He explained that when additional layers such as health systems or private equity are introduced, decision-making becomes more complex and diluted. In his view, the best environment is one that supports independent physician judgment.
He sees consolidation as a tool rather than a threat.
“I think consolidation is inevitable,” Mr. Blom said. “But I actually view it as a positive for independent practice. If consolidation is what you need to do in order to retain that autonomy, that’s a good challenge.”
Independent practice ownership continues to decline — just 42.2% of physicians worked in physician-owned practices in 2024, down from 60.1% in 2012, according to the American Medical Association.
Unlike many groups, IBJI has not faced physician shortages. Mr. Blom credits its divisional model, which optimizes teams and staffing flexibility.
“We do not experience physician shortages,” he said. “It’s more a question of making sure all of the positions are appropriately optimized in their skill.”
Nationally, workplace pressures are acute. Sixty-three percent of physicians say there aren’t enough qualified doctors to fill openings, according to a 2025 Medscape survey. The Association of American Medical Colleges projects a national shortfall of up to 86,000 physicians by 2036.
Regulatory and payer shifts are also driving strategy. Mr. Blom pointed to the move from inpatient to ASC, site-neutral payments and the role of AI in overhead management.
“We’re entering a season where AI is going to have a profound effect on our ability to manage overhead,” he said. “It’s a race for us to understand the application of AI and how we’re going to do it.”
Outpatient orthopedic care continues to accelerate. Outpatient orthopedic volumes surged 29.9% from January 2022 to May 2023, reaching approximately 485,000 procedures per month — while inpatient orthopedic volumes remained largely flat at around 14,300 monthly cases.
Major ASC operators are doubling down on orthopedic services. Surgery Partners performed over 29,000 orthopedic cases in Q1 2025, marking a 3.4% year-over-year increase, with total joint replacements jumping 22%.
IBJI was also an early adopter of value-based care, with most joint and spine patients in bundled or risk-based programs. The group has also built its own digital patient navigation and risk-stratification tools.
“We learned a decade ago you have to have control over your own digital space,” Mr. Blom said. “That flexibility allows us to connect with patients in person, virtually and digitally.”
Looking ahead, Mr. Blom expects IBJI to expand urgent care access points and refine team structures while continuing to consolidate strategically.
“We are and remain optimistic about independence and autonomous practice,” he said. “We think that running the model we do is important for the community, important for society and important to keep a balance of availability for value.”
