Measuring Value in Orthopaedics: The U.S. and U.K. Perspectives.

Area of Science:

• Health Economics
• Health Services Research
• Clinical Quality Measurement

Background:

• The U.S. and U.K. lack standardized definitions for value in specialty care, hindering optimization of patient outcomes and resource use.
• Existing value-based care models show modest savings but lack a true understanding of impact on patient-centric outcomes or appropriate intervention selection.

Purpose of the Study:

• To highlight the critical need for a standardized metric to measure value in specialty care.
• To advocate for the adoption of the incremental cost-effectiveness ratio (ICER) as a framework for value-based healthcare.

Main Methods:

• Review of existing value-based specialty care initiatives in the U.S. and U.K.
• Conceptual framework development for measuring healthcare value using ICER.

Main Results:

• Standardized value metrics are essential for comparing treatment options based on cost and patient outcomes.
• The incremental cost-effectiveness ratio (ICER) integrates quality-adjusted life years, cost, and effectiveness duration.

Conclusions:

• Healthcare systems should adopt ICER-based frameworks to transition from volume to value-based models.
• ICER facilitates shared decision-making, reduces care variation, and supports strategic site-of-service decisions.
• Implementing ICER supports innovation, accountability, and whole-person musculoskeletal specialty care.