Economic Incentives in Orthopaedic Surgery: A Primer

➢ Orthopaedic surgeon pay structures are diverse, but most commonly are productivity-based.➢ Physician ownership of ambulatory surgery centers is a growing phenomenon and may have effects on clinical decision-making.➢ Hospital systems are paid by multiple mechanisms, including case-based reimbursement (based on Diagnosis-Related Groups). Incentives are substantially different between the types of payers (Medicare and Medicaid compared with private insurance).➢ Payer revenues stem from risk-adjusted premiums and investments in income-generating assets; a growing focus on cost-effective care and outcome-focused data by payers has led to changes in pay structures.