For those of you who did not make it to the AAOS’ annual meeting in San Diego last week, you missed something pretty remarkable. “Tale of Two Cities” seems like the perfect title to describe the story that presented itself in San Diego this year. 

     If you browse the program, “bundled payments” was the topic of discussion 23 times across scientific exhibits, posters and breakout sessions.  Sharing tips and strategies on making the most of this reimbursement model to debating clinical impacts were the overarching themes.  It’s quickly taking center stage because bundled payments are the new reality, regardless of the administration in office.  We’ve seen them from CMS, and in the last few years, commercial payors are implementing them successfully as well.  On top of all of this, AAOS coordinated an opportunity for reporters to ask two leading orthopaedic surgeons for their thoughts on bundled payments.  While the mere fact that AAOS coordinated this “press conference” is newsworthy in and of itself, both surgeons expressed the notion that bundled payments are becoming the new normal.

     As an attendee, you leave the convention center with your head swimming in value.  You are looking down at your shoes as you walk, pondering the future and how you are going to continue your success in the new and permanent world of pay-for-performance.  You look up at 5th Street to get your bearings, and at first glance, you wonder how long you’ve been walking.  Are you in a different city hosting an orthopaedic conference? There’s no way vendors are ponying up millions of dollars to rent out an entire block as a playground when surgeons in meetings are discussing optimizing healthcare spend to save our country from disaster.  But alas, it’s true.  On two nights, two different vendors got to smear their colors across an entire city block in San Diego in a “drinks on us” move to raise awareness for their products. The showboating would have been appropriate for Sony at the electronics expo in Vegas; not an implant manufacturer at a medical conference.  Why?  Because  there’s a difference in getting excited about purchasing a video game console and a total knee replacement.  Flaunting money at the expense of millions of Americans in need of care is tasteless.  Vacations are put on hold and double-shifts are taken to save up for the care the average American needs to cover co-pays on total joint procedures.  As one surgeon put it, “This is US Healthcare, not Disneyland.”

     Success for orthopaedic implant companies is starting to look very different, although given the display, it seems that some still have not woken to this fact.  America needs an implant vendor who gets it.  One that has done away with frivolous sales and marketing spending in the name of focusing on outcomes and value.