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Industry        Surgeon

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Who Will Hold the Power in Healthcare?

Posted in Health Reform Watch | Feb 2015 | Comments (1)

Tags: Editor's Choiceorthopaedic industry trendspatient protection and affordable care acthealth insurancehealthcare costsobama carepatient volume


Increased consumerism in healthcare has guided the decision making and consulting of many of the surgeons on the ORTHOPRENEUR Editorial Board in recent years.

“If patients are becoming consumers, evolving into shoppers (reference pricing) for healthcare, then providers need to look to the retail industry for guidance,” wrote Marshall Steele, M.D., in December 2014 on why patient volume still matters.

Blaine Warkentine, M.D., MPH launched the SurgeryTrack app because “Consumerization of healthcare is the largest push, but there’s also a big push for value-based reimbursement, which means you can bundle the whole procedure as an episode for one price. You can go to the market and say, ‘I can do this procedure for this price.’ When you can say that, the payors, the employers and the consumers say, ‘Oh I know what I’m going to pay. I’m going to buy that one. I have outcomes and I have a price; now I know what the value is of that service and that’s what I’ll choose.’ ”

“The market/consumer should decide what is worthwhile to purchase. If a patient wants to undergo an intra-articular injection with an unproven treatment such as platelet rich plasma for knee arthritis, I do not have a problem with that as long as the patient is paying the $800 for the treatment and not a third-party payor,” wrote Blair Rhode, M.D., earlier this month about opportunities in a free market.

Patients are asking more questions about options for care. This is guided by variables such as an increased use in healthcare technology and gadgets, increased deductibles and increased dialogue by employers trying to mitigate concerns over the Affordable Care Act.

Will this translate to consumers taking ultimate control of healthcare? The question, “What entity in the healthcare chain—hospitals, surgeons, Medicare, insurance companies, etc.—will hold the most power five years from now?” was asked to device company and surgeon leaders at the ORTHOWORLD Symposium, The State and Future of the Orthopaedic Industry™, in January 2015.

Their answers shocked some of the device company professionals and supplier partners to the device company who were in attendance. The speakers’ responses are summarized below. What is your reaction? Tell us in the comments.

Sonny-Bal WEBB. Sonny Bal, M.D., J.D., Chairman, President, CEO of AMEDICA: This may sound odd, but I believe that if not five, then in ten years, the power will be with the consumer. This whole paradigm will shift from the industry; surgeon knows best; there will be pricing transparency, if not today, then tomorrow. If we don’t do it in this country, then patients will go offshore to get healthcare.

Starting this month, our entire hospital system is allowing every patient digital access to his own hospital records. That used to be a no-no. Once, you could dictate things in the chart that weren’t politically correct, and you can’t do that anymore. I welcome that.

At some point, the patient is going to demand, what am I really paying for? This information has been hidden from consumers, and if you believe in open pricing models and freedom of information, which I do, I think the power will pass to the consumer for the better.

It’s an eye-opener as to how much control patients will have in their digital watch, in their sensors, in their EKGs, in their blood pressure and blood glucose monitoring. Someday, they will have portable x-ray machines in their houses. That changes the entire paradigm.

Rod-Mayer-web
Rod K. Mayer, President,
Nextremity Solutions:I share that sentiment. I’ve been told that I’m altruistic in that perspective. I know a gifted foot and ankle surgeon on the West Coast who has treated patients in all 50 states and has patients flying in to his own surgery center from around the world. He’s focused on four elective procedures in the forefoot. All of these patients are out of network, but he has positioned himself to address the desires of the consumer, which is the patient. 

Doug-Kohrs WEB
Doug W. Kohrs, Past President and CEO, Tornier:
I agree that it will be the consumer, but I don’t think it will be in five years. I think it will be in ten or 15, a little bit longer time period.

Dr. Bal said something similar. I think that the evolution of power will move from the doctor or the surgeon, more to the hospital administrator, to the government and then to the patient, all with the emphasis on cost.
 

Selene WEBSelene G. Parekh, M.D., surgeon entrepreneur, partner at the North Carolina Orthopaedic Clinic and Associate Professor of Orthopaedic Surgery at Duke University: The government will hold the power, to be honest. Obamacare, the Affordable Care Act, this change with EMRs. It’s a slow way down toward a universal health system. One payor, one EMR and the government will regulate everything. I’m not trying to talk about it in a surreptitious or malicious way, but I think that’s where we’re going, and it’s going to be a slow path down that road. Government will say, okay, if we control it all, then we can control cost.

If you look at other countries, that’s not always the case. The grass is always greener; the problem is that we’ve decided our grass isn’t green enough. So we’ve decided as a country, we want to start doing other things to rein in cost. And I agree with that, but you have to do it in a smart way.


Carolyn LaWell is Content Manager at ORTHOWORLD. She can be reached by This e-mail address is being protected from spambots. You need JavaScript enabled to view it .

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Rhode 03/21/2015 10:23 PM
I agree with Dr. Parekh. We are on a march to a single payer model. The problem is that Obamacare has added so many costs and taxes that the consumer is conquered. If I paid for what I received, free market (the consumer would reign). If you are taking 16% of my income (1/6 of the economy) to run a wealth transfer scheme that I HAVE to participate, I am going to get in line and wait for my government provided healthcare (like Canada and Britain). I will either be so broke or see it as my responsibility/ owed to me. If I spend $20,000 a year on health care premiums/taxes, I'll wait in line for what is owed to me. No my friends, the game is over.