With the approach of 2026, U.S. orthopedic leaders are zeroing in on the forces reshaping their field, from reimbursement cuts and insurance instability to AI innovation, surgical advances and growing patient demand. Here’s what’s weighing most on their minds as they look ahead.
Question: As you look toward 2026, what’s the one priority, challenge or opportunity that’s really sitting on your mind right now?
Editor’s note: Responses have been lightly edited for clarity and length.
R. Carter Cassidy, MD. Chair of Orthopedic Surgery and Sports Medicine at UK HealthCare (Lexington, Ky.): The biggest thing weighing on my mind is concern about the 2.5% reduction in the CMS fee schedule.
It is getting tougher to hire and retain talented orthopedic surgeons to do the volume of work at major centers and in smaller communities. Further devaluation of our work is only going to lead to less great physicians in the workforce, longer wait times for patients and [will] likely lead to patients feeling like they are “just a number” in doctor-patient interactions.
Our department is happy to be very busy, and maintaining access for patients that need to get in is only going to get tougher as our work is further disincentivized. It becomes harder for smaller private practices in rural communities to survive. Patients absolutely get better care when there are private and academic options for their care, and further cuts to payments will only hasten the demise of the independent practices.
Tan (Dan) Chen, MD. Orthopedic Spine Surgeon at Inova Orthopaedics and Sports Medicine (Fairfax, Va.): As I look toward 2026, one priority is supporting Inova’s initiative to expand its orthopedic spine presence across the D.C. metropolitan and Northern Virginia regions. This is both a strategic opportunity and a personal mission. My goal is to help bring that vision to life by growing a robust, high-quality spine practice that meets the needs of a rapidly expanding patient population.
I’m focused on delivering patient-centered, highly tailored and cutting-edge spine care as part of a coordinated system that raises the standard of spine health in the region. That includes leveraging advanced technologies, building strong referral relationships and driving initiatives that improve access, outcomes and the overall patient experience.
I also see this as an opportunity to position Inova as the premier destination for spine care, contributing through clinical excellence, program development and leadership within the broader orthopedic community. By aligning my growth with Inova’s strategic goals, I hope to play a meaningful role in shaping the future of spine care in this region.
Tyler Gonzalez, MD. Associate Professor of Orthopedic Surgery at the University of South Carolina (Columbia): What is top of mind for me are advances in minimally invasive foot and ankle surgery, the growing role of AI in patient care and training, expanded use of VR for residents and fellows and continued progress in biologics.
Eric Grossman, MD. Clinical Assistant Professor in the Department of Orthopedic Surgery at NYU Grossman School of Medicine (New York City): My major concern for 2026 and beyond focuses on the fiscal downtrends toward physicians that are unsustainable. CMS has proposed reallocating dollars from speciality care to primary care, assuming specialists can offset decreasing reimbursement through greater efficiency, but many fields — including adult reconstruction orthopedics — are already at historically highest efficiency levels.
It’s not clear why this must be an either/or scenario, as specialists have always been rewarded for providing higher-risk care. I agree primary care should be properly rewarded, but creating a binary choice that pits specialties against one another is flawed.
Physicians’ ability to lobby effectively has been limited compared to groups like the [American] Bar Association or the insurance lobby due to fractionalized representation. Primary care, surgeons, specialists and nurses all deserve reimbursement adjusted for inflation, yet no single voice effectively advocates for physicians.
Despite delivering better outcomes, physician pay has declined while insurers’ profits have grown, driving many physicians from private practice into employment models. This misallocation of healthcare dollars threatens long-term sustainability and makes the profession less attractive to the best and the brightest, a shift no population should want. Reversing this trend through stronger physician representation and lobbying is essential.
David Kalainov, MD. Medical Director of Orthopedics at Northwestern Memorial Hospital (Chicago): The biggest challenge to the U.S. healthcare system in 2026 will be insurance coverage. Population health will predictably decline, and the overall cost of care will increase if millions of U.S. residents lose or forego coverage.
John Kennedy, MD. Chief of the Division of Foot and Ankle Surgery and Professor in the Department of Orthopedic Surgery at NYU Langone Health (New York City): Heading into 2026, I am looking forward to the rapid evolution of in-office needle arthroscopy, driven by next generation systems such as the Arthrex 2.0 NanoScope.
The new scope will feature 720-by-720 resolution, 120-degree field of view and a 1.9 millimeter sheath with integrated inflow for fluid management. The improved optics and expanded instrumentation will allow surgeons to better diagnose and treat pathologies with patients fully awake, and I am excited to use this new technology.
William Levine, MD. Frank Stinchfield Chair of Orthopedic Surgery at Columbia University (New York City) and Orthopedic Surgeon-in-Chief at NewYork-Presbyterian/Columbia: My priority for 2026 is to further deepen my commitment to providing the best possible care for every patient I see. As I’ve grown in my career, I’ve come to truly value the outpatient physician-patient relationship in a way I didn’t fully appreciate when I was younger. My experience allows me not only to diagnose problems efficiently but, more importantly, to clearly communicate expectations and outcomes so patients genuinely understand what lies ahead.
And when surgery is the best option, my goal is to ensure that patients have true informed consent. To support this, I’ve created educational videos to help patients better understand the surgical process, as I’ve found that traditional, lengthy paperwork is far less effective.
C. Benjamin Ma, MD. Chair of the Department of Orthopaedic Surgery at the University of California, San Francisco: My main focus and priority is maintaining the department and our faculty’s focus on innovation and education. With the recent challenges, we as academic leaders need to continue to focus on new discoveries and training the next generation of orthopedic surgeons.
Douglas Padgett, MD. Surgeon-in-Chief and Chair of Orthopedics at Hospital for Special Surgery (New York City): The catch phrase for 2025 was “it’s all about AI.” That’s great, but 2026 will be the year to implement: time to get to work!
At HSS, we intend to use technology not to replace people, but to enable and empower our people to better the processes we build to improve patient care, patient access and the entire patient experience. AI is not the solution; it is part of the solution. It will facilitate our goal of getting the right patient to the right provider at the right time. This is the power of technology.
Christian Pean, MD. Assistant Professor of Orthopaedic Trauma Surgery and Executive Director of AI and IT Innovation in the Department of Orthopaedic Surgery at Duke University School of Medicine (Durham, N.C.): Heading into 2026, one priority for me is proving that AI-enabled care coordination can measurably improve outcomes and close care gaps in orthopedics, not just make workflows more efficient.
With shrinking margins, limited staffing and CMS pressure to move cases off the inpatient-only list and into shorter-stay, outpatient pathways, technology has to help us safely expand access rather than simply shift risk.
I also think that we have to reimagine the “front door” to care: moving beyond phone tag and clunky portals toward AI-supported, patient-friendly channels that balance quality, access and growth.
Bryan Springer, MD. Chair of Orthopedic Surgery at Mayo Clinic Florida (Jacksonville): Declining CMS reimbursement remains one of the most pressing challenges facing physicians nationwide and continues to accelerate consolidation across healthcare, often without proven benefits in quality or cost.
I also view this as a major opportunity for orthopedic surgeons to demonstrate the value we bring through exceptional outcomes, efficiency and a relentless focus on patient-centered care. Even amid financial pressure, our responsibility is to show that high-quality care can be delivered responsibly and sustainably.
We must also harness the power of AI to reduce administrative burden and improve care delivery, while preserving the human connection that defines us as healthcare providers. Now, more than ever, physicians need to lead healthcare reform, or we risk creating significant access issues for our patients in the years ahead.
Stephen Thompson, MD. Sports Medicine Orthopedic Surgeon at Northern Light Orthopedics (Bangor, Maine): Heading into 2026, I am concerned the CMS efficiency adjustment does not reflect the increasing complexity of orthopedic care. The assumption that surgery can simply become more efficient over time contradicts current data and places additional strain on all orthopedic practices, both private and employed. Policies based on inaccurate efficiency expectations risk destabilizing care delivery and ultimately limiting patient access to timely musculoskeletal treatment.
Joseph Zuckerman, MD. Chair of Orthopedic Surgery at NYU Langone Health (New York City): For me, in 2026, the focus will be on the impact of federal legislation on healthcare availability and access. A decrease in the number of insured will have an impact on individual practices, groups and the institutions where care is provided. Significant concerns exist until some clarity can be provided.
Bruce Ziran, MD. Orthopedic Surgeon at Atlanta Orthopedic Institute: I see the corporatization of healthcare as one of the big issues. Systems that devalue physician input and leadership become corporate behemoths with lip service to quality. They focus on volume and profit and hire substandard physicians and providers who become cogs in the wheels of revenue. Alternate models that value physician leadership and skill will need to differentiate themselves from the corporate systems.
As an example, consider vendor choices for surgeons. Hospitals lament supply costs but have no problem spending tens or hundreds of millions on new sites and real estate — different corporate dollar “buckets,” so to speak. Forcing single-source vendors is a power play that devalues physician autonomy and restricts access to cutting-edge technology. Why can’t they allow capitated pricing that allows for cost containment and physician autonomy?
The corporate model takes the “profession” away from the professionals and makes them commodities, or worse, boxes to check off and discard when they don’t “align” with the corporate agenda. I have seen morale differences in different healthcare environments, and the morale and value of the physicians seem related to the quality of care delivered. Time will tell what the public prefers.
