For years, orthopedic practices could rely on inbound referrals from other healthcare providers to consistently fill their patient roster. But changes in the orthopedic market—including the shift to value-based care, the rise of healthcare consumerism, and the influx of digital musculoskeletal companies (digital MSKs)—are forcing orthopedic practices to think outside the box and potentially step outside their comfort zone.
Traditional orthopedic practices are feeling the pressure to maintain—and gain—patient volume as the market looks to cannibalize their business. It’s critical for independent practices to find alternative ways to capture patients earlier in their care journey and get them on the right care path. However, not all patient volume is equal; packing a patient roster with more commercially insured patients will boost overall reimbursement. Orthopedic practices have an opportunity to compete more effectively and earn more market share by tapping into new patient populations through the direct-to-employer model.
As employee benefit costs continue to rise, business leaders are prioritizing programs to improve employee health and wellness and ultimately reduce medical spend. With MSK conditions leading healthcare spending, many employers are keen to provide employees with easy access to an orthopedic benefit for treating acute and chronic conditions. The success of this business model has been proven by the rapid growth of digital MSKs, through contracting directly with self-insured employers and promising medical cost reduction.
Orthopedic practices should take a page out of the digital MSK playbook and monetize the employer market—without imposing the risks of digital MSKs to patients and employers. Unfortunately for the employer and employee, digital MSKs are targeting the wrong cost containment problem—diverting patients away from traditional orthopedic practices—and doing so in a dangerous way. The real cost problem is when employees use the emergency department (ED) as a default source of care when a need arises. Each year, privately insured patients account for 18 million unnecessary ED visits, adding $32 billion to annual healthcare costs.
While orthopedic care should not begin and end with virtual therapy, telehealth-enabled solutions allow employers to provide low-cost access to care, empower patients to match with the right provider, and help all parties avoid high ED and urgent care costs. In today’s economic climate, orthopedic providers are leaving money on the table if they are not providing digital access to employers and adding commercially insured employees to their roster.
Without a formal employer strategy, traditional orthopedic practices will likely get stuck at a baseline number of patients or even start actively losing patients. By engaging with employers, orthopedic practices can establish a direct referral system and a steady stream of new patients. In this model, the orthopedic practice maintains exclusive rights to certain patient populations. When employees in their network sustain work-related injuries or require orthopedic care, their employer refers them directly to the contracted practice.
As orthopedic practices contract with new organizations, they begin fostering long-term relationships with benefits managers and employees, building trust and familiarity. When an employee leaves their organization or needs to refer a family member for orthopedic care, their practice will be top of mind. With increased access points to a larger pool of patients, practices can expect to experience a higher rate of scheduled appointments, receive ongoing referrals, and create a more stable patient base.
Independent orthopedic providers have the benefit of being embedded in their local communities, giving their practices a major advantage to win contracts with local self-insured employers. Partnering with local employers presents a unique opportunity for orthopedic practices to gain market share while staying true to their roots and continuing to serve their community. The key is to find businesses with the right employee population—ones with individuals likely to need orthopedic care during their careers.
Due to the nature of their work, employees in certain industries—including healthcare, retail, manufacturing, and transportation—are more likely to experience an MSK-related injury or have chronic MSK conditions. Orthopedic providers should align with these types of local employers not only to compete with digital MSKs and other practices, but also to enhance the patient experience and improve health outcomes in their communities. Further, digital tools allow practices to offer immediate virtual access to local orthopedic specialists or in-person care, streamlining the employees’ experience of finding, scheduling, and getting to the right care.
The bottom line is that orthopedic practices need to increase access points to patients through employers. Practices slow to change will be at the whims of payers and digital MSK companies controlling the patient flow, which could end in a race to the bottom. But logically, it’s intimidating to explore a new frontier, and most practices simply don’t have the resources to find and foster employer relationships. To ensure these relationships create long-term value for all—the employer, employees, and providers—orthopedic practices need to adopt modern strategies and tools and find a partner that knows the process from soup to nuts.
Hatch provides digital solutions that help orthopedic practices get every patient in the right place. As a result, patients receive the optimal level of care, and practices maximize their strategies for growth.
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