The Quality Conundrum: Recognizing and Reckoning With Musculoskeletal Healthcare Disparities

Area of Science:

• Healthcare policy
• Health equity
• Musculoskeletal medicine

Background:

• Significant disparities in musculoskeletal healthcare access and outcomes exist based on race, ethnicity, sex, and socioeconomic status.
• Current value-based healthcare models, while aiming for efficiency, have inadvertently exacerbated these existing inequities.
• Comorbidities disproportionately impact vulnerable populations, further widening the healthcare gap.

Purpose of the Study:

• To analyze how value-based healthcare models affect musculoskeletal health disparities.
• To identify strategies for surgeons and health systems to mitigate these disparities.
• To emphasize the need for equitable quality reporting and risk stratification.

Main Methods:

• Review of current value-based healthcare delivery and reimbursement methodologies.
• Analysis of risk adjustment and reporting initiatives impacting healthcare systems.
• Examination of patient-surgeon interactions and health system data collection.

Main Results:

• The transition to value-based care has unintentionally intensified musculoskeletal healthcare disparities.
• Bias and lack of shared decision-making contribute to inequitable care.
• Health systems can leverage demographic data and disparity-related reporting to promote equity.

Conclusions:

• Surgeons must understand the impact of value-based models on health equity.
• Addressing bias and implementing shared decision-making are crucial at the patient-surgeon level.
• Developing equitable quality reporting measures and risk stratification models is essential for achieving equitable musculoskeletal healthcare for all.