In November, The Alliance was invited to address the American Academy of Orthopedic Surgeons (AAOS). It was the third time we’ve done so in as many years. Our role at this meeting was to share what employers/purchasers are doing to manage the cost of orthopedic care from the “buy side”. It is the area where Alliance members spend the most money and is also the area where our costs are increasing the fastest.

I was able to tell a very motivating story about how employers are encouraging their employees to use “best value” providers through reference pricing or by offering gift cards to seek care from providers whose costs are lower and whose quality is on par with their higher cost counterparts – at least based on our current ability to measure quality. And therein lies the challenge to AAOS. Meaningful quality measurement of orthopedic care is still relatively primitive compared to the more advance work being done by specialties like cardiology. The reasons are many, but include not collecting the right data (like changes in patient functional status) and the longer time frame needed to detect some quality issues (like whether knee and hip replacements last).

AAOS is stepping forward as a professional society to identify ways to measure, improve and publicly report on the quality of care. Part of the motivation is that self-funded employers and insurance companies are moving market share to high value providers using the best available, if imperfect information. Thanks to them, we’ll get better information and better care.

Hats off to those of you who are providing this important “wind in the sails” to the orthopedic profession and to the courageous leaders of AAOS who are advocating for a significant investment of resources to move meaningful quality measurement forward.