Maintaining a Successful Orthopaedic Practice in a Post-ACA World

Michael A. Swarzman, MA, MBA

As a group, orthopaedic surgeons repeatedly demonstrate a strong, focused, and independent (entrepreneurial) spirit. As a clinical discipline, orthopaedics historically has been one of the most profitable services for hospitals and health systems. With the passage of the Patient Protection and Affordable Care Act (ACA) in 2010, however, the rules for maintaining a successful orthopaedic practice changed virtually overnight.

The former hallmarks of success—competency, availability, professional identity and recognition, communication with referring physicians, and the provision of market-differentiated care—simply may not be enough to ensure future success. Orthopaedic practices will also need to capture outcome data, explore new governance structures, and manage competitive tensions in a post-ACA world.

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