The Quality Conundrum: Recognizing and Reckoning With Musculoskeletal Healthcare Disparities

Disparities in musculoskeletal health care exist across race, ethnicity, sex, and socioeconomic status. Because medical and socioeconomic comorbidities disproportionately affect certain patient populations, the transition to a value-based model of healthcare delivery and reimbursement based on current methodology has unintentionally intensified musculoskeletal healthcare disparities. To address healthcare disparities, surgeons must understand the history and effect of a value-based model of healthcare delivery and reimbursement and the current risk adjustment and reporting initiatives that inform future directions of healthcare systems. Attention to bias and the use of shared decision making at the patient-surgeon level may help promote more equitable care. At the health systems level, surgeons can collect demographic data via registries and use existing disparity-related reporting measures to promote more equitable care. The development of quality reporting measures and risk stratification models that encourage the delivery of equitable musculoskeletal health care for all patients is necessary.