title: Pay-for-performance in orthopedics: how we got here and where we are going.
abstract: OBJECTIVE
  Recent health laws have shifted from the traditional fee-for-service model toward a pay-for-performance model. In this changing climate, it is imperative that a provider understands these changes and recognizes the importance of health services research on medicine.
  
  
  RESULTS
  Increasing the value of care by improving quality and decreasing cost has been the focus of several projects. Preventing complications may be an effective way to increase value. Patient risk stratification is a modifiable variable that will allow for improved patient selection. This in turn may reduce adverse events, thereby lessening the economic burden of complications, increased length of stay, and hospital readmission. Providers must partner with their hospitals to align their goals and maximize quality and efficiency in order to decrease costs.
authors.affiliation: Orthopaedic Surgery Department, Virginia Commonwealth University, 1200 E Broad Street; 9th floor, P.O Box 980153, Richmond, VA, 23298, USA.
authors.forename: Ashton H
authors.initials: AH
authors.lastname: Goldman
authors.affiliation: Orthopaedic Surgery Department, Virginia Commonwealth University, 1200 E Broad Street; 9th floor, P.O Box 980153, Richmond, VA, 23298, USA. Stephen.Kates@vcuhealth.org.
authors.forename: Stephen
authors.initials: S
authors.lastname: Kates
keywords: Bundled care; MIPS; Pay-for-performance; Risk stratification; Value-based reimbursements