title: Economic Impact of Orthopedic Adult Reconstruction Office Practice: The Implications of Hospital Employment Models on Local Economies.
abstract: The purpose of this study was to evaluate the economic attributes of private practice adult reconstruction (AR) offices. 458 AAHKS surgeons responded; 65% were in private practice (fee-for-service, non-salaried, non-employed AR surgeons). 54% had considered hospital employment in the past two years. The average group employs 13.4 orthopedic surgeons (3.4 AR), and 105 other employees. The average total budget is $12.5 million per year with $4 million in salaries, and $238,000 in tax revenue generated. Co-management joint ventures are a better model than hospital employment for aligning AR surgeons and hospitals and realizing the cost effectiveness and quality improvement goals of PPACA and AARA while preserving the economic impact of AR private practice.
authors.affiliation: New York University Langone Medical Center Hospital for Joint Diseases.
authors.forename: Richard
authors.initials: R
authors.lastname: Iorio
authors.affiliation: OrthoCarolina, Charlotte, North Carolina.
authors.forename: Thomas
authors.initials: T
authors.lastname: Fehring
authors.affiliation: University of Washington, Tacoma, Washington.
authors.forename: Sally
authors.initials: S
authors.lastname: York
authors.affiliation: Cleveland Clinic, Cleveland, Ohio.
authors.forename: Mark
authors.initials: M
authors.lastname: Froimson
authors.affiliation: University of Vermont, Burlington, Vermont.
authors.forename: David
authors.initials: D
authors.lastname: Halsey
authors.affiliation: OrthoCarolina, Charlotte, North Carolina.
authors.forename: Susan
authors.initials: S
authors.lastname: Odum
authors.affiliation: Hershey Medical Center, Hershey, Pennsylvania.
authors.forename: Charles M
authors.initials: CM
authors.lastname: Davis
authors.affiliation: Sharp Memorial Hospital, San Diego, California.
authors.forename: Richard
authors.initials: R
authors.lastname: Santore
authors.affiliation: New York University Langone Medical Center Hospital for Joint Diseases.
authors.forename: Louis F
authors.initials: LF
authors.lastname: McIntyre
mesh_terms: D000328:Adult; D019643:Arthroplasty, Replacement / Q000191:economics; D003695:Delivery of Health Care / Q000191:economics*; D004651:Employment / Q000191:economics; D018166:Health Care Reform / Q000191:economics; D019538:Health Care Surveys; D006759:Hospital-Physician Joint Ventures / Q000191:economics*; D006801:Humans; D008505:Medical Staff, Hospital / Q000191:economics*; D019637:Orthopedic Procedures / Q000191:economics*; D009985:Orthopedics / Q000191:economics*; D010820:Physicians / Q000191:economics; D010824:Physicians' Offices / Q000191:economics; D011331:Private Practice / Q000191:economics*; D019651:Plastic Surgery Procedures / Q000191:economics; D011795:Surveys and Questionnaires; D014481:United States
keywords: PPACA; adult reconstruction; economic impact; hospital employment; private practice; total joint arthroplasty