How Orthopedic Market Trends Are Shifting Care Models

Orthopedic service lines are operating amid accelerating competitive pressure, rapid migration to outpatient settings, rising technology investment, staffing constraints, and evolving reimbursement models that increasingly demand proof of value and medical necessity. These market trends are reshaping the delivery and financing of orthopedic care.

Independent practices are finding it harder to stay afloat, and hospitals are trying to determine if they can keep enough orthopedic volume to continue inpatient programs. For health systems and the companies that support them, these shifts are more reality than theory. They directly influence capital allocation, partnership strategy, and long-term sustainability across the orthopedic devices market and related service lines.

Multiple Orthopedic Market Trends are Converging at Once

Where is Patient Volume?

Market forces shifting patient volume include payer preference for lower-cost outpatient settings, a proposal from the Centers for Medicaid and Medicare (CMS) to remove orthopedic (musculoskeletal) procedures from the inpatient-only list, and an increasing number of patients who prefer the convenience of ambulatory surgical centers over the perceived complexity of a hospital.

Federal policy changes and improved technology continue to accelerate this shift, placing pressure on health systems to re-evaluate where orthopedic surgical procedures are performed, and which sites of care remain economically viable.

Increased Competition

Ambulatory surgical centers are growing rapidly. Their single specialization facilitates highly efficient workflows, streamlined patient volume, and same-day recovery. Despite their increasing numbers, individual ASCs are facing staff shortages that dampen growth plans.

At the same time, hospitals are being forced to reassess the volume they can realistically retain and whether inpatient programs can survive. When the dust settles, the current state of care delivery will change.

Smart Technology is at the Fore

Technology innovation is advancing faster than most healthcare providers can operationalize it. Robotic systems, AI-enabled surgical planning tools, and advanced technology such as smart implants promise greater surgical precision, reduced administrative burden, and improved patient outcomes.

AI can reportedly generate surgical plans in minutes rather than weeks, while smart implants track range of motion and recovery patterns to improve patient outcomes after surgery. Yet these gains come at a significant expense, forcing financially constrained organizations to weigh adoption timelines, ROI, and long-term scalability across orthopedic surgery and complex procedures.

Burnout and Independent Practice Pressures

Workforce strain is no longer confined to individual clinicians. It has become a system-level risk affecting access, capacity, and growth, particularly as procedure volume increases for joint reconstruction, revision surgeries, and other high-demand orthopedic surgical procedures.

As independent practices consolidate or exit the market, health systems must absorb greater responsibility for staffing, call coverage, and continuity of care, often without proportional reimbursement gains.

Medical Necessity is Being Redefined

Perhaps the most consequential shift is the redefinition of medical necessity. Expanded prior authorization requirements, reimbursement scrutiny, and oversight of orthopedic implants and surgical instruments are reshaping how orthopedic care is approved, delivered, and defended.

Where Executive Convening Plays a Role

At THMA’s Orthopedics Forum, system-level orthopedic leaders and select industry executives come together in a closed-door setting designed for candid, peer-level exchange. These conversations are not presentations. They are working sessions focused on navigating uncertainty across the orthopedic sector, including care delivery models, technology adoption, and market dynamics that influence company growth and global orthopedic sales.

Members engage directly on the operational and structural systems most resistant to change, including data reporting infrastructure, call coverage models, OR utilization, and the evolving role of advanced practice providers. These challenges are deeply embedded in legacy systems that determine whether orthopedic programs remain competitive amid significant growth expectations and rising costs.

Rather than prescribing answers, the forum surfaces the questions leaders are actively wrestling with:

• Leveraging AI to enhance the OR: How can health systems adopt new technology to enhance operational OR efficiencies and improve care delivery given current financial constraints?

• Aligning Ambulatory Surgery Centers (ASC) with Health System Goals: What strategies must be developed to integrate ASCs seamlessly into broader health system priorities?

• Integrating Value-Based Care: How can value-based care be embedded into orthopedic programs, while balancing procedure volume, cost efficiency, and patient-centered care across the continuum?

Moving forward, orthopedic leaders know they must convene with peers to share confidential insights and find ways to ensure seamless, high-quality care for patients.

In an environment defined by uncertainty, progress rarely comes from isolated decision-making. It comes from open dialogue, shared experiences, and trusted relationships. That is the role Executive Convening plays for leaders shaping the future of orthopedic care.