Skip to main content
SpringerLink
Log in

Health Care Organization and Its Impact on Care of Diseases of the Hip

  • Chapter
Book cover Diagnosis and Management of Hip Disease

  • 1047 Accesses

Abstract

United States (U.S.) healthcare expenditures outpace that of other industrial nations and are not necessarily associated with improved health outcomes. To contain costs and improve quality and coverage in the U.S. healthcare system legislation has mandated a reorganization of healthcare around accountable care organizations (ACOs), patient-centered medical homes (PCMHs), and bundled payments. ACOs and PCMHs utilize bundled payment schemes and represent novel delivery models, implemented as part of the Patient Protection and Affordable Care Act (PPACA), that will impact the care of diseases of the hip. New modes of healthcare delivery incentivize a shift toward provider-led organizations and establish a population health model that is oriented toward primary care as well as the management and prevention of orthopedic pathology across the entire continuum of disease pathology and care cycle. As healthcare continues to reorganize the orthopedic profession is faced with unique challenges including ensuring equal access to vulnerable population segments, minimizing non-value adding interventions and addressing supply side issues as demand for hip procedures increases.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 59.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 79.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Gruber J. The cost implications of health care reform. N Engl J Med. 2010;362(22):2050–1. Epub 2010/05/14.

    Article  CAS  PubMed  Google Scholar 

  2. Woolhandler S, Campbell T, Himmelstein DU. Costs of health care administration in the United States and Canada. N Engl J Med. 2003;349(8):768–75. Epub 2003/08/22.

    Article  PubMed  Google Scholar 

  3. Himmelstein DU, Woolhandler S. Cost without benefit. Administrative waste in U.S. health care. N Engl J Med. 1986;314(7):441–5. Epub 1986/02/13.

    Article  CAS  PubMed  Google Scholar 

  4. Moses 3rd H, Matheson DH, Dorsey ER, George BP, Sadoff D, Yoshimura S. The anatomy of health care in the United States. JAMA. 2013;310(18):1947–63. Epub 2013/11/14.

    Article  CAS  PubMed  Google Scholar 

  5. Shinkman R. IOM report calls for universal coverage. Healthc Leadersh Rep. 2004;12(1):11–2. Epub 2004/04/06.

    PubMed  Google Scholar 

  6. McIntyre LF. Exploring new practice models delivering orthopedic care: can we significantly decrease delivery costs and improve quality? Sports Med Arthrosc. 2013;21(3):152–4. Epub 2013/08/09.

    Article  PubMed  Google Scholar 

  7. Fisher ES. Building a medical neighborhood for the medical home. N Engl J Med. 2008;359(12):1202–5. Epub 2008/09/19.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  8. Lansky D, Nwachukwu BU, Bozic KJ. Using financial incentives to improve value in orthopaedics. Clin Orthop Relat Res. 2012;470(4):1027–37. Epub 2011/10/18.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Satin DJ, Miles J. Performance-based bundled payments: potential benefits and burdens. Minn Med. 2009;92(10):33–5. Epub 2009/11/18.

    PubMed  Google Scholar 

  10. Matlock D, Earnest M, Epstein A. Utilization of elective hip and knee arthroplasty by age and payer. Clin Orthop Relat Res. 2008;466(4):914–9.

    Article  PubMed Central  PubMed  Google Scholar 

  11. Nwachukwu BU, Kenny AD, Losina E, Chibnik LB, Katz JN. Complications for racial and ethnic minority groups after total hip and knee replacement: a review of the literature. J Bone Joint Surg Am. 2010;92(2):338–45. Epub 2010/02/04.

    Article  PubMed Central  PubMed  Google Scholar 

  12. Fiscella K, Franks P, Doescher MP, Saver BG. Disparities in health care by race, ethnicity, and language among the insured: findings from a national sample. Med Care. 2002;40(1):52–9. Epub 2001/12/19.

    Article  PubMed  Google Scholar 

  13. Schoenfeld AJ, Tipirneni R, Nelson JH, Carpenter JE, Iwashyna TJ. The influence of race and ethnicity on complications and mortality after orthopedic surgery: a systematic review of the literature. Med Care. 2014;52(9):842–51. Epub 2014/08/08.

    Article  PubMed  Google Scholar 

  14. Liu JH, Zingmond DS, McGory ML, SooHoo NF, Ettner SL, Brook RH, Ko CY. Disparities in the utilization of high-volume hospitals for complex surgery. JAMA. 2006;296(16):1973–80. Epub 2006/10/26.

    Article  CAS  PubMed  Google Scholar 

  15. Irgit K, Nelson CL. Defining racial and ethnic disparities in THA and TKA. Clin Orthop Relat Res. 2011;469(7):1817–23. Epub 2011/04/07.

    Article  PubMed Central  PubMed  Google Scholar 

  16. Mahomed NN, Barrett JA, Katz JN, Phillips CB, Losina E, Lew RA, Guadagnoli E, Harris WH, Poss R, Baron JA. Rates and outcomes of primary and revision total hip replacement in the United States medicare population. J Bone Joint Surg Am. 2003;85-a(1):27–32. Epub 2003/01/21.

    Google Scholar 

  17. Borkhoff CM, Hawker GA, Kreder HJ, Glazier RH, Mahomed NN, Wright JG. Patients’ gender affected physicians’ clinical decisions when presented with standardized patients but not for matching paper patients. J Clin Epidemiol. 2009;62(5):527–41. Epub 2009/04/08.

    Article  PubMed  Google Scholar 

  18. Schulman KA, Berlin JA, Harless W, Kerner JF, Sistrunk S, Gersh BJ, Dube R, Taleghani CK, Burke JE, Williams S, Eisenberg JM, Escarce JJ. The effect of race and sex on physicians’ recommendations for cardiac catheterization. N Engl J Med. 1999;340(8):618–26. Epub 1999/02/25.

    Article  CAS  PubMed  Google Scholar 

  19. Kurtz SM, Lau E, Ong K, Zhao K, Kelly M, Bozic KJ. Future young patient demand for primary and revision joint replacement: national projections from 2010 to 2030. Clin Orthop Relat Res. 2009;467(10):2606–12. Epub 2009/04/11.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Fehring TK, Odum SM, Troyer JL, Iorio R, Kurtz SM, Lau EC. Joint replacement access in 2016: a supply side crisis. J Arthroplasty. 2010;25(8):1175–81. Epub 2010/09/28.

    Article  PubMed  Google Scholar 

  21. Lofvendahl S, Eckerlund I, Hansagi H, Malmqvist B, Resch S, Hanning M. Waiting for orthopaedic surgery: factors associated with waiting times and patients’ opinion. Int J Qual Health Care. 2005;17(2):133–40. Epub 2005/01/25.

    Article  PubMed  Google Scholar 

  22. Chen D, Berger RA. Outpatient minimally invasive total hip arthroplasty via a modified Watson-Jones approach: technique and results. Instr Course Lect. 2013;62:229–36. Epub 2013/02/12.

    PubMed  Google Scholar 

  23. Berger RA, Sanders SA, Thill ES, Sporer SM, Della Valle C. Newer anesthesia and rehabilitation protocols enable outpatient hip replacement in selected patients. Clin Orthop Relat Res. 2009;467(6):1424–30. Epub 2009/03/03.

    Article  PubMed Central  PubMed  Google Scholar 

  24. Berger RA. A comprehensive approach to outpatient total hip arthroplasty. Am J Orthop (Belle Mead NJ). 2007;36(9 Suppl):4–5. Epub 2007/12/06.

    Google Scholar 

  25. Parvizi J, Mui A, Purtill JJ, Sharkey PF, Hozack WJ, Rothman RH. Total joint arthroplasty: when do fatal or near-fatal complications occur? J Bone Joint Surg Am. 2007;89(1):27–32. Epub 2007/01/04.

    Article  PubMed  Google Scholar 

  26. Mather 3rd RC, Wysocki RW, Mack Aldridge 3rd J, Pietrobon R, Nunley JA. Effect of facility on the operative costs of distal radius fractures. J Hand Surg Am. 2011;36(7):1142–8. Epub 2011/05/31.

    Article  PubMed  Google Scholar 

  27. Healy D, Cromwell J, Thomas FG. Repricing specialty hospital outpatient services using ambulatory surgery center prices. Health Care Financ Rev. 2007;29(2):81–90. Epub 2008/04/26.

    PubMed Central  PubMed  Google Scholar 

  28. Robinson JC. Case studies of orthopedic surgery in California: the virtues of care coordination versus specialization. Health Aff (Millwood). 2013;32(5):921–8. Epub 2013/05/08.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Academic Training, Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA

    Benedict U. Nwachukwu MD, MBA

  2. Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, 1912 Speedway, Austin, TX, 78712, USA

    Kevin J. Bozic MD, MBA

Authors
  1. Benedict U. Nwachukwu MD, MBA
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kevin J. Bozic MD, MBA
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kevin J. Bozic MD, MBA .

Editor information

Editors and Affiliations

  1. Department of Orthopedics, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA

    Roy K. Aaron

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Nwachukwu, B.U., Bozic, K.J. (2015). Health Care Organization and Its Impact on Care of Diseases of the Hip. In: Aaron, R. (eds) Diagnosis and Management of Hip Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-19905-4_1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-19905-4_1

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-19904-7

  • Online ISBN: 978-3-319-19905-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation