Blog

Leveraging Ancillary Services: A Strategic Response to Declining Reimbursement in Orthopedics

TL;DR: The landscape of healthcare is ever-evolving, and orthopedic physicians find themselves navigating through challenges, including the constant pressure of declining reimbursement rates. As traditional revenue streams become less reliable, orthopedic practices are turning to ancillary services as a strategic response to maintain financial stability while providing comprehensive care to patients.

Understanding Declining Reimbursement

Orthopedic physicians face a multifaceted challenge with decreasing reimbursement rates from insurance companies and government payers. This decline can be attributed to various factors, including regulatory changes, the shift towards value-based care, and increasing administrative burdens. To overcome these financial hurdles, many orthopedic practices are exploring the potential of ancillary services.

5 Ancillary Services for Orthopedics

Ancillary services refer to additional healthcare offerings that complement the primary services provided by a medical practice. In the context of orthopedics, these services can include physical therapy, diagnostic imaging, ambulatory surgery centers (ASCs), durable medical equipment (DME), remote patient monitoring (RPM), and more. By incorporating these ancillary services into their practice, orthopedic physicians can not only enhance patient care but also generate additional revenue streams.

  1. Physical Therapy (PT): Integrating physical therapy within the orthopedic practice allows for a comprehensive approach to patient care. This not only improves patient outcomes but also creates an additional source of revenue for the practice. Offering in-house physical therapy services can also enhance the overall patient experience, making it more convenient for patients to access the necessary care under one roof.

  2. In-House Diagnostic Imaging: Many orthopedic conditions require imaging services for accurate diagnosis and treatment planning. By establishing in-house diagnostic imaging facilities, orthopedic practices can streamline the diagnostic process, reduce patient wait times, and generate revenue through imaging services. This approach not only benefits the practice financially but also contributes to a more efficient and patient-centric model of care.

  3. Ambulatory Surgery Centers (ASCs): Performing outpatient surgeries in an ASC can be a lucrative venture for orthopedic practices. ASCs are known for their cost-effectiveness and efficiency, providing orthopedic surgeons with a controlled environment to perform surgeries on an outpatient basis. This not only reduces the overall cost of care but also allows practices to capture a portion of the revenue that might otherwise go to hospitals.

  4. Durable Medical Equipment (DME): Dispensing durable medical equipment directly from the orthopedic practice can be a valuable ancillary service. Whether it’s braces, crutches, or other orthopedic devices, offering these items in-house not only provides convenience for patients but also creates an additional revenue stream.

  5. Remote Patient Monitoring (RPM/RTM): Remote Therapeutic Monitoring (RTM) or Remote Physiologic Monitoring (RPM) can be an especially valuable ancillary service for orthopedic practices. It can be used with postoperative patients to track their recovery and detect complications as quickly as possible. It can also be used preoperatively for patient optimization. All of which takes place from the comfort of the patients’ home. And it’s reimbursable through Medicare, Medicaid and most commercial insurances.

Conclusion

In the face of declining reimbursement, orthopedic physicians must proactively seek solutions to sustain their practices financially. Ancillary services present a strategic response, allowing orthopedic practices to diversify their revenue streams while providing comprehensive care to patients. By strategically implementing services such as physical therapy, diagnostic imaging, ambulatory surgery centers, durable medical equipment, and remote patient monitoring technologies, orthopedic practices can navigate the challenges of the healthcare landscape, ensuring both financial viability and quality patient care.

Prescribe FIT is a full-service remote patient monitoring and virtual lifestyle health solution that extends orthopedic care beyond the office to address the root cause of orthopedic patients’ musculoskeletal (MSK) conditions. Contact us to learn more.

Published on January 12, 2024