title: Value-based shoulder surgery: practicing outcomes-driven, cost-conscious care.
abstract: BACKGROUND
  Pathology of the shoulder contributes significantly to the increasing burden of musculoskeletal disease. Currently, there exists high variability in the nature and quality of shoulder care, and outcomes and cost reporting are not uniform. Value-based practice aims to simultaneously maximize outcomes and minimize costs for given disease processes.
  
  
  METHODS
  The current state of the shoulder care literature was examined with regards to cost and outcomes data, initiatives in streamlining care delivery, and evidence-based practice improvements. This was synthesized with value-based care theory to propose new avenues to improve shoulder care in the future.
  
  
  CONCLUSIONS
  The treatment of shoulder disorders is ideal for the value-based model but has been slow to adopt its principles thus far. We can begin to advance value-based practices through (1) the universal reporting of outcomes and costs, (2) integrating shoulder care across provider specialties, and (3) critically analyzing data to formulate best practices.
authors: The Harvard Shoulder Service, Massachusetts General Hospital, Brigham and Women's Hospital, Boston, MA 02114, USA.
authors: Eric M
authors: EM
authors: Black
authors: Laurence D
authors: LD
authors: Higgins
authors: Jon J P
authors: JJ
authors: Warner
mesh_terms: D017046:Cost Savings; D003362:Cost-Benefit Analysis; D005260:Female; D017048:Health Care Costs; D006801:Humans; D008297:Male; D018803:Models, Economic; D019637:Orthopedic Procedures / Q000191:economics* / Q000379:methods; D017063:Outcome Assessment, Health Care / Q000191:economics*; D010818:Practice Patterns, Physicians' / Q000191:economics; D012785:Shoulder Joint / Q000503:physiopathology / Q000601:surgery*; D014481:United States