Orthopedic organizations are integrating AI into prior authorization workflows, opening surgery centers and implementing clear clinical pathways to boost profitability and outcomes.
These initiatives have led to fewer delays and denials, diversified revenue streams and greater control over implant and supply costs, all while committing to improving the patient experience.
Three orthopedic C-suite leaders and administrators recently connected with Becker’s to share what have been some of the most effective strategies to improve their outcomes and sustainability.
Note: Responses were lightly edited for clarity and length.
Question: What has been the most effective strategy your organization has implemented in the past year to improve both orthopedic/spine outcomes and financial sustainability?
Paul Bruning. Division Administrator of the Duke University Sports Medicine, Hand and Sports Sciences Institute (Durham, N.C.): The Duke Orthopedics Department has integrated AI into the prior authorization workflow to proactively review clinical documentation before submission to payers. Given that payers now rely on AI-driven systems for authorization decisions, this alignment enables early identification of documentation deficiencies that could otherwise lead to denials or peer-to-peer reviews.
As a result, we have seen improved approval rates, fewer peer-to-peer requests and reduced delays in patient care. This initiative has been positively received by clinicians and operational teams and represents a meaningful step toward more efficient, technology-enabled care delivery.
Patrick Magallanes. President and CEO of Steindler Orthopedics (North Liberty, Iowa): Over the past year, the most effective strategy Steindler Orthopedics implemented to improve orthopedic and spine outcomes and financial sustainability was the full integration and launch of our physician-owned six-room Steindler Surgery Center. By thoughtfully shifting appropriate procedures from the hospital to our purpose-built ASC, we enhanced care coordination from clinic visit through postoperative recovery, standardized evidence-based surgical pathways, improved efficiency and delivered a highly personalized patient experience. Financially, the ASC allows us to control site-of-service costs, manage operating room utilization and mitigate ongoing clinic reimbursement reductions as labor, supply and technology expenses continue to rise year over year. By diversifying our revenue streams through the surgery center, we have created a more sustainable model that preserves our independence, supports reinvestment in our people and infrastructure and ensures continued access to high-quality orthopedic care for the communities we serve.
Raghu Reddy. Chief Administrative Officer of MiOrtho Surgery Center (Southfield, Mich.): MiOrtho Surgery Center’s strategy to improve orthopedic and spine outcomes while ensuring long-term financial sustainability is built on an episode-based operating model (clinic decision through 90-day recovery) that emphasizes standardization, continuous improvement and transparency. We implement practical clinical pathways with clear, realistic targets across clinical outcomes, patient experience and financial performance, and we routinely track and benchmark KPIs, sharing results with staff and providers to identify improvement opportunities, analyze root causes and implement changes with discipline.
Patient feedback and education are central to our approach. We maintain a simple, expectations-driven pre-op optimization process led by specialized RN navigators — one of our strongest levers for improving outcomes — while continually refining patient selection and perioperative flow through input from surgeons and staff. Financially, we focus on controlling implant and supply costs through progressive standardization (while protecting outcomes), and we strengthen performance through a high-performing revenue cycle team that supports smooth operations and maximizes collections.
