On Sept. 9, 2013, the day Congress returned from their summer recess, the AAOS placed the first of several informational ads in Politico, Roll Call, and The Hill—publications that are regularly read by policy makers, legislators, and their staffs. The ads are designed to draw attention to a series of studies quantifying the value of an orthopaedic procedure using real healthcare dollars.
The ad features a sketch of the human body showing the musculoskeletal system (Fig. 1). Captions explain the advantages of orthopaedic surgery along with the societal and economic savings gained from surgeries performed each year.
The first study, which was published in The Journal of Bone and Joint Surgery (JBJS) in August, focused on total knee replacement procedures. Four additional studies—examining the value of treatments for rotator cuff tears, hip fractures, anterior cruciate ligament (ACL) tears, and spinal fusion—are in the works. The series is funded by the Academy as part of the A Nation in Motion® campaign.
Congressional debates on important healthcare and quality issues, including the sustainable growth rate formula and in-office ancillary services, focus on cost and value for both patients and society. Unfortunately, these debates tend to focus strictly on surgical expenses, without taking into account the potential costs to society if patients do not receive appropriate surgical treatment. The JBJS-published study demonstrates the positive impact orthopaedic procedures can have on patients and the economic value provided for society at large.
According to the study, the 600,000-plus total knee replacement surgeries performed in the United States in 2009 will generate about $12 billion in savings to society over the lifetimes of those patients. About 85 percent of those savings are associated with increased employment and earnings; the remaining 15 percent are linked to fewer missed work days and lower disability payments.
“This new model of measuring value can be used to evaluate societal benefits for all types of healthcare services,” said study author and healthcare economist Lane Koenig, PhD. “These data offer evidence on the societal effects of successful treatment of osteoarthritis of the knee that will add to the conversation people are having about improved, cost-conscious health care.”
As concerns about the deficit, the budget, and healthcare payments increase pressure on legislators to find cost-cutting measures, this series of studies demonstrates, along with the accompanying ads and other public relations and government relations efforts, the necessity of orthopaedic procedures and the great value they provide, not only to patients, but also to society.
For example, AAOS-sponsored content for The Hill, a daily Congressional enewsletter, used real patient examples submitted to the ANationinMotion.org website to illustrate how total knee replacement enabled patients to return to work.
“For everyone’s sake, the definition of value must not be dictated by the sticker price of the orthopaedic procedure or treatment,” stated John R. Tongue, MD, AAOS past president. “We also need to have a clearer picture of factors such as a patient’s ability to remain independent and productively employed or the savings realized by avoiding payments for disability or long-term care. Patients experience the value of health care based on how they feel and what they are able to do. We will always have more research to do, but we have found a way to come much closer to measuring the economic value of that experience to all of us.”
More about the studies is available at www.ANationInMotion.org/value/knee
Elizabeth Fassbender is the communications specialist in the AAOS office of government relations. She can be reached at firstname.lastname@example.org