As a successful, independent surgical practice, Orthopedic Associates faces stiff competition in St. Louis—a highly competitive market for orthopedic care. The practice embarked on a journey to stand out from the crowd and enhance their competitive edge. Their strategic collaboration with HealthMe has yielded impressive outcomes that resonate with their commitment to quality care and innovation.
- By embracing transparent pricing, they have managed to make a substantial difference in their patient experience and practice efficiency.
- Orthopedic Associates is on track to achieve a full 100% year-over-year increase in direct pay patient revenue.
- With the implementation of HealthMe’s automation tools, Orthopedic Associates has streamlined administrative processes both in call center and back-office operations.
Consumers have become increasingly conscious of healthcare costs, and often seek clear and upfront pricing information before making decisions about medical services. This Case Study highlights the journey of Orthopedic Associates as they developed a strategy to create price transparency initiatives to gain a competitive advantage while also deploying a direct-pay platform to best serve the needs of their patients, streamline office workflows, and expand the revenue goals of their practice.
ABOUT ORTHOPEDIC ASSOCIATES
Since 1958, Orthopedic Associates has grown to be one of St. Louis' leaders in advanced orthopedic care. Their expert team of orthopedic surgeons, doctors, physician assistants, and nurse practitioners is among the area's best providers—dedicated to compassionate, specialized musculoskeletal care to get people back to their active, healthy lifestyle.
With four locations in Missouri and one location in Illinois, Orthopedic Associates serves its patients with fast, convenient access to musculoskeletal care. Featuring 12 different orthopedic specialties, including sports medicine and joint replacement, their team works across the continuum to develop personalized, fairly priced treatment plans that meet the individual needs and goals of each patient.
Built upon a set of core values including innovation, community, accountability, respect, and excellence, the team at Orthopedic Associates strives to always stay true to these values and provide the community with the best in orthopedics.
Building upon nearly 70 years of service, Orthopedic Associates has built deep ties to their community. At the same time, they face stiff competition in what is a saturated market for orthopedic care. St. Louis is home to well-regarded academic medical centers and large hospital systems with a known reputation in orthopedic care. These institutions often attract patients from across the region, increasing the competition for providing top-quality care. In a market such as this, patients have elevated expectations regarding the quality of their care.
Additionally, the competition to attract business from the growing ecosystem of direct payers, including self-insured employers, is fierce.
In a market where it is increasingly difficult to differentiate, promoting quality along with transparency and “apples to apples” pricing consistency in their direct contracting approaches is seen by Orthopedic Associates as an operating strategy to better compete against much larger players.
Expanding on their strategic investments in outpatient surgery, “injury access clinics” which provide urgent care services, imaging, and a full range of services in convenient locations, Orthopedic Associates has built a well-earned reputation in the community and is well positioned to advance its competitive position based on quality and convenience.
Orthopedic Associates leadership has developed a clear competitive advantage in that the out-of-pocket cost to their patients is significantly less than if they're seen by one of the orthopedic surgeons employed by one of the big hospital systems in the market. With the same levels of quality as the major institutions, Orthopedic Associates can provide both faster access to care as well as compete on prices that are significantly lower because of the massive overhead cost borne by their competitors.
NEXT STEPS—OWNING THE BUNDLE
Working together with the client success team at HealthMe, Orthopedic Associates’ strategy will be to compile and deploy a comprehensive library of transparently priced surgical bundles—and to make sure those prices are clearly presented as part of the practice communication strategy. HealthMe will provide vital expertise in removing the complications from creating these bundles based on years of refining a proven process, a proprietary dataset, and experience with many of the major independent orthopedic practices across the US.
With a pending agreement with an ambulatory surgical center recognized for its continued excellence, coupled with the deployment of transparently priced bundles, Orthopedic Associates will be able to meet the needs of both direct-pay markets—self pay patients and self-insured employers—with a single solution.
In early 2022, Orthopedic Associates and HealthMe began a partnership that was originally focused on providing a technology platform to meet the needs of direct pay patients. At that time, leadership at Orthopedic Associates realized they were missing a rapidly growing, but unaddressed market of direct payers who comprise a natural product/market fit for their 12 orthopedic specialties—along with the ability to sell durable medical equipment to support patients in their care and recovery process.
Since launching HealthMe, Orthopedic Associates has seen the following results and improvements:
- On track to increase direct pay patient revenue100% year over year
- Replacement of inefficient call center activities and unnecessary paperwork with HealthMe’s automated SMS messaging for patient pre-payment
- Reduced administrative staff time by automating the Good Faith Estimates (GFE) process; time savings of approximately 1-hour for each GFE
- Build and retain new revenue stream with surging eCommerce sales of durable medical equipment (DME) via the branded practice website
In a highly competitive market, where healthcare organizations offer similar services, price transparency and bundled services can be a key differentiator. By meeting and surpassing consumer expectations in terms of quality and convenience, Orthopedic Associates will now be offering transparently priced surgical bundles. This combination of attractive and competitive pricing while maintaining and elevating the community care they have provided for nearly seventy years should serve them well in their efforts to attract patients and payers seeking value and quality for their money.
“With HealthMe, I'm confident we will be able to show employers, brokers, and plan administrators that they are going to receive exceptional service and quality for their employee at a lower cost.”