Event Overview

The upcoming Becker’s Healthcare webinar, Roadblocks to Scaling Electronic Prior Authorization — And How Leaders Are Moving Forward, will delve into the current challenges and emerging strategies in electronic prior authorization (ePA) adoption. Scheduled for June 3, 2025, at 12:00 PM CDT, this virtual event is built around the insights of more than 60 healthcare leaders who participated in roundtables organized by InterSystems.

As health systems and payers navigate the rollout of CMS’ Interoperability and Prior Authorization Final Rule (CMS-0057-F), this session will unpack implementation obstacles, clarify what’s required versus recommended, and highlight scalable solutions across care settings.

Designed for orthopaedic professionals, administrators, and clinical IT leaders, this webinar is a must-attend for those managing high-volume practices impacted by prior authorization delays—particularly in orthopaedic and surgical care environments.

Key Objectives

• Break down the complexities of CMS-0057-F and what it means for provider workflows
• Identify core issues stalling ePA rollouts in orthopaedic and multispecialty settings
• Explore actionable investment strategies and phased implementation approaches

Program Highlights

This 60-minute session will feature in-depth discussion and expert insights from InterSystems thought leaders, including:

• Steven Berkow, Senior Advisor, Value-Based Care, InterSystems
• Jessica Jowdy, Manager, Healthcare Sales Engineering, InterSystems

Key topics include:

• CMS-0057-F: Required vs. recommended elements and why that matters
• Common roadblocks: From workflow misalignment to CMS provision gaps
• Smart segmentation: Tailoring IT investments to provider types
• Roundtable recap: What 60+ payer and provider leaders had to say
• Live Q&A session

Who Should Attend

This webinar is tailored for orthopaedic surgeons, ASC directors, spine care professionals, healthcare CFOs, clinical operations leads, and IT decision-makers seeking to future-proof their approach to prior authorization and optimize care delivery efficiency.

Why Participate

Attendees will gain:

• A deeper understanding of how regulatory changes impact orthopaedic practices
• Real-world strategies for overcoming rollout and workflow barriers
• Opportunities to engage directly with interoperability experts and healthcare peers

For more information and to register, visit the Becker’s Healthcare event page.

The post Becker’s Webinar: Roadblocks to Scaling Electronic Prior Authorization appeared first on Orthopaedics 411™.

Payment reductions and Medicare Advantage plans are tightening reimbursement

The 2024 Medicare Physician Fee Schedule cut the conversion factor by 3.4 percent. This reduction affects reimbursement for the in-office services that make up a significant portion of most orthopaedic practices. Imaging, evaluation codes, management codes, and minor procedures now generate lower revenue, even as fixed costs continue to rise.

At the same time, Medicare Advantage plans are expanding. They now enroll over half of the Medicare population. These plans often pay less than traditional Medicare, require more prior authorizations, and delay payment processing. If your patient base includes Medicare Advantage enrollees, you’re likely seeing a steady increase in administrative work, reduced reimbursement per case, and growing delays in care delivery.

Operational changes are allowing practices to stay functional

Many practices are rethinking how they manage daily operations. Outsourcing billing, prior authorization, and coding services has helped some groups reduce administrative costs and focus more time on patient care. Joining larger networks or forming partnerships has also become common. These structures allow for shared infrastructure and improved contract negotiations with commercial and Medicare Advantage payers.

You also may already be using EHR platforms optimized for value-based care reporting. These systems can streamline documentation, track performance measures, and minimize penalties from CMS programs such as MIPS. Some practices have revised scheduling templates, increased telemedicine availability, or added mid-level providers to manage low-acuity visits. All of these tactics help maintain access and offset reimbursement losses.

Ancillary services and outpatient surgery are increasing practice revenue

Diversifying income sources is one of the most effective ways to reduce reliance on declining professional fees. Ancillary services like physical therapy and in-office imaging can provide steady revenue and support more complete patient care. If your practice offers these services, you’re likely seeing improvements in continuity, adherence, and per-visit value.

Ambulatory surgery centers are another core part of this strategy. Physician-owned ASCs offer more control over aspects such as costs, staffing, and case selection. CMS continues to approve more procedures for the ASC setting, which gives you flexibility in managing surgical care. For many practices, moving appropriate cases out of the hospital setting has led to faster turnover and fewer cancellations.

Regenerative treatments are also gaining interest. Cash-pay procedures like platelet-rich plasma injections and stem cell therapies are increasingly common. These services require patient education and careful documentation but can strengthen your brand and expand your care offerings. If you’re exploring this area, strong marketing and defined patient selection criteria are essential.

Bundled models and value alignment are gaining attention

While fee-for-service still dominates, many practices are exploring ways to participate in bundled payment models. Total joint replacements are a primary example. Bundled models offer a single payment for the entire episode of care, from preoperative evaluation to post-discharge recovery. If you’re participating, you’ve likely made changes in care coordination, patient selection, and post-acute planning to meet cost and outcome targets.

These models can help you align clinical decisions with reimbursement. When executed well, they allow for predictable revenue and stronger payer relationships. You may be piloting these programs with hospital partners or participating in CMS initiatives like BPCI Advanced. Success requires accurate data and a focus on long-term results rather than visit-based volume.

Advocacy is influencing payment policy and practice viability

While these adjustments help in the short term, long-term solutions require changes at the federal level. The American Academy of Orthopaedic Surgeons continues to advocate for a more sustainable Medicare payment model. Their priorities include eliminating budget neutrality requirements, implementing annual inflation adjustments, and supporting surgical specialties in value-based arrangements.

Other specialty groups, such as the Congress of Neurological Surgeons, are backing bipartisan efforts to stabilize annual updates and reduce volatility in Medicare payment policy. These efforts are gaining support, but meaningful reform remains slow. Participating in these advocacy efforts through email campaigns, legislative visits, or committee involvement can help amplify your voice and protect your future income.

If you haven’t engaged with these efforts, the AAOS Advocacy Action Center offers tools for contacting lawmakers and tracking proposed bills that affect orthopaedic practice. Regular participation ensures decision-makers hear from physicians managing the direct consequences of these payment trends.

Continued adaptation will determine long-term practice health

The ongoing reduction in Medicare reimbursement is forcing orthopaedic practices to make permanent changes. Many practices are redesigning internal systems, building out cash-based services, and investing in outpatient surgical facilities to maintain revenue and improve control.

Even with these strategies in place, the current Medicare structure will continue to present challenges unless there is meaningful reform. The practices that remain viable will be those that combine clinical efficiency with strategic planning and advocacy involvement. You’re already making hard decisions in response to external pressures.

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role Which best

Which best describes your current orthopaedic role or setting?

• Private practice physician (solo or group)
• Hospital-employed orthopaedic surgeon
• Academic medical center
• Outpatient surgery center provider
• Physician assistant or nurse practitioner in orthopaedics
• Practice administrator or manager
• Resident or fellow

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The post Surviving the Medicare Cutbacks: What Orthopaedic Practices Are Doing Differently appeared first on Orthopaedics 411™.

You’re probably already using some of the raw inputs a digital twin would need — MRI data, motion analysis, gait reports, implant performance. What DTs add is integration. Instead of juggling individual pieces of information, you get a living model that brings them together in one place, structured around a patient’s real anatomy and movement. It doesn’t replace your judgment. It just lets you test it first.

Digital twins build on models you already trust 

If you’ve used finite element models or multibody simulations in research or device planning, then you already know what a digital twin is made of. The difference is that DTs are tied to real patients, often updated with sensor data or imaging inputs that evolve over time. For musculoskeletal care, that includes joint contact mechanics, load distribution, muscle force predictions, and range-of-motion analytics. 

Here’s how digital twins are already helping in clinical decision-making 

In knee osteoarthritis, patient-specific DTs have been used to model how cartilage wear patterns progress under various loading conditions. A clinician can simulate altered gait patterns or brace interventions and project how they might delay joint space loss. 

In spine care, models have recreated adolescent scoliosis progression. You can adjust disc stiffness, growth rates, and brace tension in the twin and see what the outcome might look like two years out before making that call in the exam room. 

In total knee arthroplasty planning, DTs are being tested to simulate implant alignment strategies. Instead of depending on templated sizing and generic kinematic predictions, you can see what effect different tibial rotations or slopes might have on patellofemoral tracking and flexion stability. 

Each example shows the same pattern. You feed in patient-specific data, define possible treatment paths, and let the twin show you what might happen. 

Surgical planning becomes more precise and more visual 

You’ve likely been through preoperative planning platforms that help estimate implant fit or alignment. A digital twin adds the next layer by letting you test outcomes. You’re evaluating how they interact with soft tissue constraints, contact pressures, and expected ranges of motion. 

Some teams are even using DTs during the planning phase to spot complications before they occur. Say you’re working on a patient with a challenging femoral deformity. Before the OR lights turn on, you simulate the plan, notice an impingement risk during mid-flexion, adjust the resection angle in the twin, and proceed with confidence. 

Postoperative tracking is starting to loop back into the model 

Wearable sensors and rehab apps already gather data on recovery. What’s new is feeding that information back into the twin to see whether recovery is on track. For example, a DT can flag an asymmetrical gait pattern that deviates from expected norms, suggesting delayed muscle recovery or joint stiffness. You get an early signal and a direction to investigate before the patient returns with pain or dysfunction. In some pilot programs, recovery data has already altered rehab timelines and reduced readmission risk. 

The roadblocks are real but they’re being tackled 

Like any new tool, DTs come with friction. If you’ve tried early systems, you might have seen: 

• Long model setup times 
• Confusing interfaces 
• Gaps in integration with PACS or EMRs
• Limited support for different implant systems or procedural workflows 

But improvements are happening fast. Standardization efforts are underway to improve data acquisition consistency and interface design. Some platforms now offer drag-and-drop model inputs or cloud-based simulations that run in minutes, not hours. And more collaborations between orthopaedic teams, engineers, and data scientists are helping align tools with actual clinical workflows. 

Digital twins won’t replace your expertise but they might sharpen it 

Think of a digital twin as a second set of eyes, not a second opinion. It lets you ask “what if” before a scalpel touches skin. It helps you anticipate outcomes instead of reacting to them. And it gives you a clearer sense of how a specific body, under specific loads, might respond to the choices you’re about to make. 

You don’t need to become a modeler or coder to make use of this. What matters is having tools that meet you where you are, whether that’s in the clinic, in the OR, or in the treatment planning room. Whether the technology becomes routine will depend on how easily it fits into your process and how reliably it improves it. 

Digital twins are starting to act like real assistants in your workflow. And as they get faster, more intuitive, and better connected to patient outcomes, the question becomes less about whether they’re the future and more about how soon they’ll be your everyday tool.

This article is intended for informational purposes only and does not constitute medical or professional advice. The content reflects emerging research, evolving clinical applications, and expert perspectives in the field of digital twin technology for musculoskeletal care. It is not a substitute for personalized medical evaluation or consultation with a qualified healthcare provider. The use of digital twins—whether in surgical planning, rehabilitation monitoring, or orthopedic decision-making—carries inherent limitations and may vary in effectiveness depending on patient-specific factors, technological platforms, and clinical protocols. Orthopaedic professionals and patients should consult with board-certified specialists to determine the most appropriate, evidence-informed course of action for individual needs. Clinical decisions should always be based on direct medical assessment and professional judgment.

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the is using

What is the greatest challenge you foresee with using digital twins?

• Technology is too complex or technical
• Integration with existing systems is difficult
• Time or resource limitations
• Concerns about accuracy or reliability
• Lack of training or support

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The post Digital Twins in Musculoskeletal Care: A Practical Look at What’s Here and What’s Coming appeared first on Orthopaedics 411™.

Event Overview

EUROSPINE 2025, Europe’s leading congress for spine care professionals, will take place October 22–24 at the Bella Center in Copenhagen, Denmark. Hosted by the Spine Society of Europe, this flagship annual event brings together spine surgeons, researchers, and allied health professionals for three days of expert-driven education, hands-on training, and global collaboration.

Known for its robust scientific programming, EUROSPINE 2025 will spotlight the latest techniques in minimally invasive surgery, robotics, spinal oncology, and deformity correction. Attendees can expect high-impact sessions that translate directly into better patient outcomes.

Key Learning Objectives

This year’s congress is designed to meet the diverse needs of the spine community—from early-career professionals to experienced surgeons. Attendees will gain practical, actionable knowledge to:

• Integrate new research into the management of degenerative, oncologic, and deformity-related spine conditions
• Master surgical innovations, including robotic-assisted procedures
• Strengthen decision-making through real-world case discussions
• Expand their professional networks through global engagement

Program Highlights

The event kicks off on Tuesday, October 21, with focused Pre-Day Courses that offer deep dives into high-demand topics:

• Lumbar Degeneration: From Principles to Robotic Application
• Spinal Metastases in 2025: Imaging, SINS Scoring, and En-Bloc Resection

Throughout the main congress, attendees can take advantage of:

• Masterclasses exploring advanced surgical techniques and clinical innovation
• White Stage Case Discussions, offering 30-minute, interactive reviews of complex cases
• Lunch Symposia each day (Oct. 22–24), featuring expert-led sessions and industry insights
• A preview of EUROSPINE EduWeek 2025, highlighting year-round learning opportunities

Who Should Attend

EUROSPINE 2025 welcomes a broad range of spine care professionals:

• Orthopaedic spine surgeons and neurosurgeons
• Residents, fellows, and early-career professionals
• Allied health professionals supporting spine care
• Researchers and innovators in spinal science
• International delegates seeking CME-accredited, evidence-based education

Whether your focus is spinal deformity, tumor resection, or minimally invasive interventions, the congress offers tailored learning that meets your clinical and career goals.

Why Participate

By attending EUROSPINE 2025, you’ll join a community committed to elevating spine care through science, technology, and collaboration. Copenhagen—an international hub of innovation and sustainability—provides a stunning, walkable venue for exchanging ideas and advancing practice.

• Earn CME credits through evidence-based sessions
• Gain hands-on experience with surgical training modules
• Learn from top-tier faculty and global thought leaders
• Forge meaningful connections with colleagues and collaborators

Registration is now open!

Visit eurospine.org for full program details, accommodation options, and travel tips.

The post EUROSPINE 2025: Advancing Spine Surgery Through Innovation and Collaboration appeared first on Orthopaedics 411™.

Event Overview

Now in its 42nd year, the San Diego Shoulder Course—presented by the San Diego Shoulder Institute (SDSI)—returns June 11–13, 2025, at the historic Hotel del Coronado in Coronado, California. This world-renowned event is recognized as the leading global conference dedicated to advancing the art and science of shoulder surgery.

Founded by James C. Esch, MD, the course has evolved from intimate discussions on arthroscopy to an international summit covering arthroplasty, fracture care, instability, and complex shoulder pathology. With a faculty of leading surgeons and thought leaders, SDSI offers unmatched educational depth, real-world surgical insights, and peer-to-peer learning in a highly engaging format.

Key Objectives

• Examine emerging evidence and surgical innovations in shoulder arthroscopy and arthroplasty
• Analyze historical and contemporary approaches to shoulder instability and fracture management
• Improve decision-making through interactive, case-based learning and expert panel discussions
• Enhance clinical competence to elevate patient outcomes in shoulder care

Program Highlights

SDSI Classic Lecture Series

Dive into four decades of procedural evolution and surgical milestones with standout sessions such as:

• Two Perspectives on the Same Topic 10 Years Apart
• The History of the Latarjet Procedure: How Did We Start, Where We Are Now, and Why It Is Not the Bristow?
• Scapular Mechanics and RSA Instability—Disparate Topics but Both Commonly Misunderstood
• Evolving Approaches to Posterior Shoulder Instability: Insights a Decade Apart

Customized Breakout Sessions

Small-group learning led by key opinion leaders tailored to support individual goals and niche clinical interests.

Surgical Demonstrations

Engage with high-definition surgical videos, narrated and analyzed by world-class shoulder surgeons.

Networking & Collaboration

Connect with over 400 orthopaedic colleagues from across the globe through structured networking and social events.

Who Should Attend

• Orthopaedic surgeons specializing in shoulder and upper extremity procedures
• Fellows and residents in orthopaedics and sports medicine
• Allied healthcare professionals supporting orthopaedic and surgical care
• Global participants interested in advanced shoulder education

Why Participate

• Experience the course consistently rated “the best shoulder course in the world”
• Earn ACCME-accredited CME credits
• Gain confidence managing complex cases with expert-driven, real-world insights
• Expand your professional network in a prestigious and inspiring coastal setting

Registration is now open!

Visit the San Diego Shoulder Institute for program details, CME information, hotel accommodations, and travel tips.

The post 2025 SDSI Course: Where Expertise Meets Innovation appeared first on Orthopaedics 411™.

PRP and MSCs continue to dominate clinical use, but with limits

Platelet-rich plasma and mesenchymal stem cells are still the most widely applied biologics in orthopedic care. You likely encounter them most often in the management of tendinopathies, muscle injuries, and joint pathologies. PRP enhances healing through concentrated growth factors, with evidence supporting use in conditions like:

• Lateral epicondylitis
• Patellar tendinopathy
• Plantar fasciopathy
• Knee osteoarthritis

MSCs, typically derived from bone marrow or adipose tissue, offer both differentiation capacity and immunomodulatory effects. However, variation in:

• Harvesting sites
• Processing techniques
• Cell counts
• Delivery methods

continues to complicate consistent results.

While these therapies are biologically plausible and supported by preclinical models, high-quality randomized controlled trials are still limited in scope. Most of your colleagues using PRP or MSCs are applying them as adjuncts rather than standalone treatments. This pattern reflects a cautious integration driven more by patient demand and anecdotal success than by robust evidence.

Tip: When using MSCs in practice, document cell source, concentration, and delivery method consistently in patient records to support internal quality tracking and eventual outcome comparisons.

Growth factors and gene expression targeting show future potential

A growing body of work now focuses on more targeted biologics, particularly growth factors and gene-regulating agents. Investigational compounds include:

• Vascular endothelial growth factor (VEGF)
• Insulin-like growth factor 1 (IGF-1)
• Bone morphogenetic proteins (BMPs)
• Atelocollagen and simvastatin for meniscal healing

In meniscal repair, biologic augmentation with these agents shows promise in preclinical studies. Delivery via hydrogels or other scaffold systems could improve outcomes, especially in avascular zones where natural healing is slow or absent. Most of these remain preclinical, so clinical uptake will depend on whether future trials confirm translational efficacy and functional benefits.

AI, nanotech, and scaffold design are reshaping biologic delivery

Biologic efficacy is increasingly tied to how therapies are delivered. Advances in artificial intelligence and materials engineering are producing new platforms that make biologic use more targeted and reproducible. Current innovations include:

• AI-optimized stem cell culture and differentiation protocols
• Nanorobots under development for localized delivery of regenerative agents
• 3D-printed scaffolds customized to patient anatomy
• Bioactive materials for sustained release of growth factors

You may soon see these tools integrated into clinical workflows, especially in high-volume centers focused on sports medicine, spine surgery, and cartilage repair.

Tip: Begin establishing a workflow for evaluating scaffold-based products now. Standardized vendor questionnaires and storage protocols can streamline future integration once clinical approval arrives.

Stress fracture management is a key testing ground for biologic utility

Stress fractures, particularly in athletic and military populations, offer a clear use case for biologics. These injuries are painful, slow to heal, and prone to recurrence. Although biologic use in this setting is still evolving, the main interventions being explored are:

• Bone marrow aspirate concentrate (BMAC)
• Platelet-rich plasma (PRP)
• Recombinant growth factors used as surgical adjuncts

Most of you using biologics for stress fractures are combining them with internal fixation. While preclinical studies suggest enhanced osteogenesis, clinical evidence remains inconclusive. Improved study design and longer follow-ups are necessary before these therapies can be recommended more widely.

Reimbursement structures remain a barrier to integration

Cost remains one of the biggest challenges in adopting biologic therapies more broadly. The 2025 CMS Physician Fee Schedule reduced payments by 2.93 percent, which impacts both surgical and nonsurgical orthopedic procedures. Barriers you are likely to encounter include:

• Lack of dedicated CPT codes for most biologic injections
• Inconsistent coverage across commercial and public insurers
• Limited bundled-payment models that include biologics
• Insufficient cost-effectiveness data to justify use in value-based contracts

Surgeons surveyed in recent studies emphasized the need for both clinical efficacy and economic justification before scaling biologic use. While pilot programs and institutional support may offset costs in some settings, broader adoption will require standardized coverage policies and demonstrable downstream savings.

Decision-making in biologics depends on clinical context and critical judgment

The field of orthobiologics continues to evolve, with new therapies entering preclinical pipelines and others gaining traction through patient outcomes and surgeon advocacy. You’re faced with balancing evidence, patient preference, surgical feasibility, and financial viability every time you consider adding a biologic therapy to a treatment plan. PRP and MSCs are here to stay, but their utility will improve with standardization and better data. Gene therapies, growth factor platforms, and AI-assisted interventions show early promise, though their impact is still years from full clinical validation.

This article is provided for informational purposes only and does not constitute medical or professional advice. The content reflects current research, expert perspectives, and industry trends in orthobiologic therapies but should not be interpreted as clinical guidance or a substitute for consultation with a qualified healthcare professional. Orthobiologic interventions—including PRP, MSCs, and growth factor therapies—carry potential risks, and their efficacy can vary based on individual circumstances and treatment protocols. Orthopaedic professionals and patients should consult with board-certified specialists to evaluate the most appropriate and evidence-based options for their specific needs. Always rely on direct medical advice for diagnosis, treatment planning, or decision-making.

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When do you anticipate biologic therapies becoming mainstream in your orthopaedic subspecialty?

• Within the next 1–2 years
• Within 3–5 years
• Within 6–10 years
• Already mainstream
• Not likely to become mainstream

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The post The Orthobiologics Pipeline: What’s Real and What’s Hype in 2025? appeared first on Orthopaedics 411™.

Event Overview

The Pediatric Orthopaedic Society of North America (POSNA) invites orthopaedic professionals to its 2025 Annual Meeting, held May 14–16, 2025, at Caesars Palace in Las Vegas. This flagship event is a cornerstone for advancing pediatric musculoskeletal care, bringing together experts, innovators, and emerging leaders to share the latest research, surgical techniques, and best practice guidelines.

Led by Program Chair Julie Samora, MD, PhD, the meeting is designed to promote excellence in pediatric orthopaedics through education, evidence-based practices, and collaborative dialogue. Attendees will have the opportunity to explore clinical updates, engage in knowledge exchange, and connect with peers in a world-class setting.

Key Objectives

• Analyze recent advances in pediatric orthopaedic care to inform surgical and clinical decisions
• Apply evidence-based guidelines to enhance musculoskeletal health outcomes in children
• Implement strategies that elevate patient safety, treatment value, and overall care quality

Program Highlights

This dynamic three-day meeting features:

Comprehensive Educational Sessions

• Lectures, symposia, and abstract presentations covering critical topics in pediatric orthopaedics
• Updates on surgical innovation, quality improvement, and patient-centered care models

Networking Opportunities

• Engage with peers, mentors, and leading experts in pediatric orthopaedics
• Social events and networking forums designed to foster collaboration and knowledge-sharing

Family-Friendly Experience

• Accompanying Persons Program offers curated activities and excursions for guests
• Convenient lodging and dining options in the heart of the Las Vegas Strip

Who Should Attend

• Pediatric orthopaedic surgeons and specialists
• Orthopaedic residents, fellows, and medical students
• Allied health professionals, including RNs, PAs, and therapists
• POSNA members, emeritus members, and international attendees

Why Participate

• Engage with the latest clinical science and surgical innovations
• Earn CME credits and access high-value continuing education
• Strengthen professional networks and collaborate with leaders in the field
• Experience a dynamic and enriching event in a vibrant location

Registration is now open!

Visit the 2025 POSNA Annual Meeting page for program details, accommodations, and travel tips.

The post 2025 POSNA Annual Meeting: Advancing Pediatric Orthopaedics appeared first on Orthopaedics 411™.

Manufacturers, hospitals, and private practices are all adapting in different ways. Many are scaling back, while others are trying to localize production or consolidate resources. Regardless of the approach, the effects are tangible. Delays in device shipments, shrinking margins, and fewer available surgical slots are becoming part of the daily reality for teams across the country. The long-term consequences of these changes are taking shape in uneven and unpredictable ways.

Tariffs are raising the cost of doing orthopaedic work

Tariff-related expenses are driving up the cost of orthopaedic care. In 2025, up to $400 million in additional costs are projected for companies like Johnson & Johnson due to ongoing U.S. and Chinese trade measures, with orthopaedic and spine devices among the hardest hit product categories. While large manufacturers may have the flexibility to absorb or redistribute these costs, you may be seeing the pressure passed down to ASC operators, hospital systems, and independent providers.

Smaller device startups, which typically have fewer sourcing options, face serious exposure. Without the resources to retool manufacturing quickly or shift suppliers outside tariff zones, these companies are experiencing slowed production timelines and narrowed margins. Even when substitute parts or devices are available, you may be relying on lower-tier alternatives that don’t align as well with surgical preferences or existing protocols. Some practices have begun delaying purchases of capital-intensive equipment altogether.

The FDA’s internal reshuffling has only added to the complications. Recent high-profile firings within the agency have disrupted communication and approvals, further slowing product pipelines. For device companies already grappling with global cost inflation, regulatory bottlenecks are making innovation riskier. You may be noticing that access to newer implant technologies or updated instrumentation has stalled in the short term.

Tip: Evaluate your most frequently used implants and instruments now. Identify secondary suppliers and build direct relationships with distributors in less-affected trade zones.

Medicaid cuts are changing how and where care is delivered

Federal efforts to reduce Medicaid spending by $880 billion over the next ten years are triggering defensive measures at both the system and provider level. These projected cuts threaten the viability of safety-net providers and could result in more than 477,000 lost jobs across the healthcare sector by 2026. States that expanded Medicaid under the ACA are especially vulnerable. Hospital spending could drop by nearly 10 percent in places like Indiana and New Mexico if current proposals are enacted.

In your practice, this may translate to:

• Fewer covered procedures for low-income patients
• Increased patient wait times for surgical consults
• Rising volumes of uninsured or underinsured patients
• Greater financial strain on multispecialty groups operating near margin

With reimbursements tightening, some hospitals are being forced to reconsider their service lines. For orthopaedic surgery, which already operates on thinner margins in rural and high-need urban areas, the risk of service reduction or outright closure is significant.

Health organizations are responding through consolidation, acquisitions, and targeted care expansions. VNS Health, for example, is prioritizing behavioral health and managed long-term care in high-need areas in an effort to diversify its Medicaid exposure and support underserved populations. While this represents a proactive approach, it does little to offset the challenges you may face in delivering high-complexity surgical care under increasingly fragile payment structures.

Tip: Consider mapping your patient base by insurance type and geographic location. This can help you anticipate reimbursement risk and identify where partnerships with community health centers or federally qualified health clinics may strengthen continuity of care.

Practice closures are accelerating in underserved areas

You may be seeing firsthand how reduced revenue and mounting expenses are forcing practices to shut down. These closures are accelerating in regions with high Medicaid reliance and fewer private-payer options. The result is a shrinking number of providers able or willing to offer orthopaedic procedures in disadvantaged communities.

Cuts to physician Medicare payments are also worsening the situation. In 2025, CMS proposed an additional 2.8 percent cut to physician reimbursements, continuing a downward trend that has persisted for two decades. Over time, the compounding effect of these reductions is narrowing the pool of viable outpatient orthopaedic providers. Without intervention, entire regions could be left with no local surgical options.

Professional organizations and trade groups are pushing back. Advocacy efforts include:

• Formal requests for Medicare payment reform
• Lobbying for streamlined device approval pathways
• Petitioning for tariff exemptions on medical imports

If your organization is not yet involved in these policy efforts, now may be the time to reconsider its stance.

Supply chains and strategy are shifting in response

Adapting to this policy environment requires you to rethink sourcing and logistics. Some large manufacturers, such as Abbott, are investing heavily in U.S.-based production facilities to buffer against supply chain disruptions and tariff exposure. While this offers some long-term hope for cost stabilization, it does little to resolve short-term availability issues. You may still face delays and higher costs when trying to access core surgical products.

Alternative strategies include increasing the use of value-based procurement models, diversifying supplier bases, and forming tighter regional purchasing alliances. These approaches require investment and organizational alignment. For smaller practices or those operating on slim margins, the transition may be infeasible without external support. The disparity between resource-rich systems and struggling independent providers is widening.

At the national level, device makers and provider networks are pushing for targeted tariff relief and long-term payment reform. Whether these efforts will succeed remains uncertain. You are working within a policy landscape that has grown more fragmented and volatile, with fewer clear paths toward financial and clinical stability.

Consequences are unfolding unevenly but unmistakably

Orthopaedic surgery is being reshaped by a convergence of policy changes. The effects are not speculative. You are already seeing increased costs, restricted access, and constrained margins. If Medicaid cuts continue and tariff-related costs remain high, access to orthopaedic care will contract further, especially for patients living in low-resource regions. The impact will not be evenly distributed.

Some organizations will adapt through vertical integration, localized manufacturing, or selective divestment. Others will not. As the year progresses, expect to see more closures, more variability in device availability, and more complex patient navigation challenges. Continued advocacy and system-level innovation will be required to keep surgical care viable for underserved populations. Without it, the next round of closures could push entire communities out of reach.

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How are increased tariffs on orthopaedic devices impacting your practice?

• We’re absorbing the costs internally
• We’ve had to raise procedure or device fees
• We’ve delayed purchasing or switched to lower-tier products
• We haven’t been significantly affected yet
• Not sure / Not applicable

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Event Overview

NSpine will host its premier Cadaveric Training Course from October 31 – November 1, 2025, at the Sunskill Laboratory, located in the Biomedical Research Institute at Stellenbosch University, Cape Town. This intensive hands-on training experience is tailored for practicing spinal surgeons eager to refine their skills in endoscopic, cervical, and anterior/lateral lumbar interbody fusion (ALIF/XLIF) procedures.

Set in a world-class facility equipped with the latest surgical simulation technologies, the course is designed to meet the training needs of working surgeons through focused cadaveric dissection, rotating expert faculty, and comprehensive theoretical support.

Key Objectives

• Perform posterior and anterior approaches to the subaxial cervical spine
• Master technical steps of ALIF/XLIF procedures and endoscopic foraminotomy
• Practice anterior decompression techniques, including discectomy and vertebrectomy
• Conduct anterior and posterior reconstructive procedures (e.g., ACDF, TDR, screw fixation)
• Gain detailed anatomical knowledge of spinal vascular, visceral, and neural structures

Program Highlights

This high-impact two-day course includes:

Hands-On Cadaveric Labs

• Full-day dissection workshops across multiple stations
• Maximum 3 delegates per station with rotating faculty for personalized training

Expert Instruction

• Faculty comprised of top-tier local and international spine surgery educators
• Training complexity scaled to each delegate’s experience level

Comprehensive Learning Materials

• Pre-course access to a curated lecture series via eccElearning
• Interactive case discussions and real-time clinical decision-making

Cutting-Edge Facility

• Held at the Sunskill Laboratory, a multimillion-rand training center featuring surgical microscopes, image-guided navigation, C-arms, O-arm, AR systems, and more

Who Should Attend

This course is ideal for:

• Spine surgeons seeking advanced cadaveric and endoscopic training
• Orthopaedic and neurosurgeons with a focus on minimally invasive techniques
• Specialists aiming to expand their skills in cervical and lumbar reconstruction
• Surgeons preparing for complex real-world operative scenarios

Why Participate

By attending this NSpine course, delegates will:

• Work in small-group settings for maximum exposure and feedback
• Learn from globally respected faculty in a state-of-the-art environment
• Improve operative performance and surgical confidence
• Join a global network of spine surgery professionals dedicated to clinical excellence

Registration is now open!

Visit the NSpine Cadaveric Training Course Registration Page for full program details, accommodation information, and cancellation policy.

The post NSpine Cadaveric Training Course 2025: Master the Art of Spine Surgery in Cape Town appeared first on Orthopaedics 411™.

Specialists across fields are moving toward the concierge model

Though originally associated with internists and general practitioners, concierge care has been adopted by a growing number of specialties including orthopaedics, rheumatology, dermatology, and cardiology. For orthopaedic practices, the concierge model creates opportunities to improve the entire surgical episode, from preoperative optimization through recovery. Some practices have used the model to provide more hands-on postoperative management, closer monitoring, and personalized rehabilitation support.

This structure depends on a fixed-fee or subscription-based payment model rather than fee-for-service billing. By limiting panel size, you can spend more time with each patient, address concerns more thoroughly, and reduce the need for rushed visits. Patients often receive same-day scheduling, direct communication access, and extended follow-up that enhances continuity of care.

You gain flexibility, fewer administrative demands, and more time with patients

If you are frustrated with insurance-driven constraints, concierge orthopaedics offers a chance to reframe your practice around the quality of each encounter rather than the number of procedures performed. Surgeons working in concierge settings report greater professional satisfaction and lower stress, especially when administrative work is reduced and autonomy increases.

Patients benefit from a more personalized care experience, but you benefit as well. With a smaller panel size and direct compensation, you can operate on a more predictable financial model. Rather than chasing billing codes and preauthorizations, you focus on building clinical relationships and improving outcomes. For many orthopaedic patients undergoing joint replacements or spinal interventions, the level of involvement available in concierge care can reduce complications and support better recovery.

Some commonly reported benefits to physicians include:

• Reduced paperwork and insurance-related overhead
• Improved scheduling flexibility
• Stronger continuity with surgical patients
• Enhanced autonomy over treatment decisions
• More predictable revenue based on membership fees

Tip: Before restructuring your practice, start by reviewing your case mix and reimbursement trends. If a significant portion of your income depends on elective cases with high patient engagement, you may have the foundation needed to support a concierge model.

Patients are increasingly receptive to subscription-based care

Interest in concierge care is growing among patients who are dissatisfied with conventional systems. In many cases, this interest is less about luxury and more about access. Long waits, short appointments, and fragmented care continue to drive patients toward alternatives. Consumer Reports found that patients across different income brackets are willing to consider membership-based practices if the value is clear. In orthopaedics, where recovery is often complex and ongoing, the appeal of more engaged, responsive care is especially strong.

The concierge model allows you to respond to this demand with services that cannot be offered in high-volume settings. You can design recovery plans that are more specific to the patient’s goals and lifestyle. You also have the option of coordinating physical therapy, pain management, and follow-up with fewer interruptions.

From a patient’s perspective, the value typically includes:

• Longer, more thorough consultations
• Faster access to surgical planning and diagnostics
• Postoperative support with fewer delays
• More direct communication with the surgeon
• Customized rehabilitation strategies

Tip: Consider surveying your patients before making changes. A short, anonymous questionnaire can help assess interest in expanded access, customized recovery plans, or bundled services, giving you insight into what your population values most.

There are ethical, logistical, and strategic challenges to weigh

Reducing your panel size may make care less available for patients who cannot afford membership or who rely on public insurance. For orthopaedic practices in communities with limited access to specialists, this shift can leave a gap in care delivery. Some physicians have expressed concern about the ethical implications of concierge care when it removes capacity from a system already stretched thin.

You may also encounter tension in referral relationships. Rheumatology practices that have adopted concierge models report that some referring providers view the model as a barrier rather than a value-added service. The same dynamic can affect orthopaedics, especially when your surgical volumes are dependent on broad community relationships.

Beyond that, transitioning requires clarity in messaging, adjustments to scheduling and billing infrastructure, and alignment with state and federal regulations. If you are considering the change, a phased or hybrid approach may be more practical. Offering concierge services to a portion of your patients allows you to assess demand and workflow changes without fully committing to a complete restructuring.

Whether this model fits depends on your values, market, and goals

You may find that concierge orthopaedics aligns with how you want to practice. It gives you the space to spend more time with patients, design care pathways that reflect your clinical judgment, and step away from the volume-driven pressures that define many surgical practices. However, the model requires buy-in from patients, careful implementation, and a willingness to accept the consequences of exclusivity.

In some markets, particularly those with high competition for premium care, the model can offer an edge. In others, it may feel disconnected from the population’s needs or the practice’s referral network. Your decision should reflect more than market trends. It should take into account how you define meaningful care and how you want to engage with your community over time. When that alignment exists, concierge orthopaedics can become more than a business strategy. It can reframe your practice around the values that brought you to the profession.

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you most concierge

What would most concern you about transitioning to concierge orthopaedics?

• Ethical considerations regarding patient access
• Potential loss of referral sources
• Uncertain patient interest or demand
• Challenges with practice infrastructure changes

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The post The Rise of Concierge Orthopaedics: Is It Right for Your Practice? appeared first on Orthopaedics 411™.