Clinical Orthopaedics and Related Research®

, Volume 467, Issue 10, pp 2556–2560 | Cite as

Executive Summary: Value-based Purchasing and Technology Assessment in Orthopaedics

Symposium: ABJS Carl T. Brighton Workshop on Health Policy Issues in Orthopaedic Surgery


As US healthcare expenditures continue to rise, reform has shifted from spending controls to value-based purchasing. This paradigm shift is a drastic change on how health care is delivered and reimbursed. For the shift to work, policymakers and physicians must restructure the present system by using initiatives such as process reengineering, insurance and payment reforms, physician reeducation, data and quality measurements, and technology assessments. Value, as defined in economic terms, will be a critical concept in modern healthcare reform. We summarize the conclusions of this ABJS Carl T. Brighton Workshop on healthcare reform.



We thank Jonathan H. Koenig for all of his hard work and help in preparing this report.


  1. 1.
    Booz-Allen-Hamilton and Boston University. Medicare Hospital Value-based Purchasing Plan Development. Boston, MA: Centers for Medicare & Medicaid Services; 2007:1–35.Google Scholar
  2. 2.
    Bourne RB, Maloney WJ, Wright JG. An AOA critical issue. The outcome of the outcomes movement. J Bone Joint Surg Am. 2004;86:633–640.PubMedGoogle Scholar
  3. 3.
    Bozic KJ, Smith AR, Hariri S, Adeoye S, Gourville J, Maloney WJ, Parsley B, Rubash HE. The 2007 ABJS Marshall Urist Award: the impact of direct-to-consumer advertising in orthopaedics. Clin Orthop Relat Res. 2007;458:202–219.PubMedGoogle Scholar
  4. 4.
    Centers for Medicare and Medicaid Services. The 2008 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds. Washington, DC: Centers for Medicare and Medicaid Services; 2008.Google Scholar
  5. 5.
    Dalury DF, Mason JB, Murphy JA, Adams MJ. Analysis of the outcome in male and female patients using a unisex total knee replacement system. J Bone Joint Surg Br. 2009;91:357–360.PubMedCrossRefGoogle Scholar
  6. 6.
    Kaissi A. Manager-physician relationships: an organizational theory perspective. Health Care Manag (Frederick). 2005;24:165–176.Google Scholar
  7. 7.
    Kusuma SK, Nunley RM, Mehta S, Genuario JW, Kennedy J. DTCA: improving patient education or simply increasing pharmaceutical profits? AAOS Now. 2007;December:26–28.Google Scholar
  8. 8.
    Ranawat AS, Dirschl DR, Wallach CJ, Harner CD. Symposium. Potential strategies for improving orthopaedic education. Strategic dialogue from the AOA Resident Leadership Forum Class of 2005. J Bone Joint Surg Am. 2007;89:1633–1640.Google Scholar
  9. 9.
    Rosenthal MB. Beyond pay for performance—emerging models of provider-payment reform. N Engl J Med. 2008;359:1197–1200.PubMedCrossRefGoogle Scholar
  10. 10.
    Terry K. Value-based purchasing alone won’t cure Medicare’s ills. BNET Healthcare. 2008. Accessed January 28, 2009.
  11. 11.
    World Health Organization. World Health Organization Statistical Information System. 2008. Available at: Accessed February 2, 2009.
  12. 12.
    Wies J. AAOS Technology Overviews. Rosemont, IL: AAOS; 2008.Google Scholar

Copyright information

© The Association of Bone and Joint Surgeons® 2009

Authors and Affiliations

  1. 1.Hospital for Special SurgeryNew YorkUSA
  2. 2.Washington University OrthopaedicsSt LouisUSA
  3. 3.University of California–San Francisco Medical CenterSan FranciscoUSA

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