The Orthopaedic Forum   |    
Medicare and the Orthopaedic Surgeon: Challenges in Providing, Financing, and Accessing Musculoskeletal Care for the Elderly*
Kevin J. Bozic, MD, MBA1; Bonnie Cramer, MSW2; Todd J. Albert, MD3
1 Department of Orthopaedic Surgery and Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, 500 Parnassus Avenue, MU 320W, San Francisco, CA 94143-0728. E-mail address: kevin.bozic@ucsf.edu
2 Chair, Board of Directors, AARP, 601 E Street N.W., Washington, DC 20049
3 Department of Orthopaedic Surgery, Thomas Jefferson University and Hospitals, 925 Chestnut Street, Philadelphia, PA 19107
View Disclosures and Other Information
Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. One or more of the authors, or a member of his or her immediate family, received, in any one year, payments or other benefits in excess of $10,000 or a commitment or agreement to provide such benefits from commercial entities (United HealthCare Pacific Business Group on Health, Integrated Healthcare Association, and DePuy Spine [royalties]).

This report is based on a symposium presented at the Annual Meeting of the American Orthopaedic Association on June 11, 2009, in Bonita Springs, Florida.

Copyright ©2010 American Society for Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2010 Jun 01;92(6):1568-1574. doi: 10.2106/JBJS.I.01189
5 Recommendations (Recommend) | 3 Comments | Saved by 3 Users Save Case


The U.S. health-care system is currently facing numerous challenges that threaten its long-term viability. Uncontrollable inflation of health-care costs coupled with concerns about highly variable quality and declining access to care have led to calls for a complete overhaul of the system1,2. The federal government, as the primary payer for a substantial portion of health care in the U.S.3, is actively involved in the debate over health-care reform. In fiscal year 2010, Medicare will provide health insurance to forty-seven million individuals who are over the age of sixty-five years, are disabled, or have end-stage renal disease, at a cost of roughly $510 billion. Over the past decade, Medicare provider reimbursement has trailed medical inflation, leading some orthopaedic surgeons to reconsider their participation in the program, others to "quietly" restrict access to Medicare patients, and a small number to completely opt out of the program. In this report, we explore various stakeholder perspectives on the challenges in providing, financing, and accessing musculoskeletal care for the elderly through the Medicare system and discuss potential strategies for addressing these challenges.
Figures in this Article

    First Page Preview

    View Large
    First page PDF preview
    Sign In to Your Personal ProfileSign In To Access Full Content
    Not a Subscriber?
    Get online access for 30 days for $35
    New to JBJS?
    Sign up for a full subscription to both the print and online editions
    Register for a FREE limited account to get full access to all CME activities, to comment on public articles, or to sign up for alerts.
    Register for a FREE limited account to get full access to all CME activities
    Have a subscription to the print edition?
    Current subscribers to The Journal of Bone & Joint Surgery in either the print or quarterly DVD formats receive free online access to JBJS.org.
    Forgot your password?
    Enter your username and email address. We'll send you a reminder to the email address on record.

    Forgot your username or need assistance? Please contact customer service at subs@jbjs.org. If your access is provided
    by your institution, please contact you librarian or administrator for username and password information. Institutional
    administrators, to reset your institution's master username or password, please contact subs@jbjs.org


    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
    CME Activities Associated with This Article
    Submit a Comment
    Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
    Comments are moderated and will appear on the site at the discretion of JBJS editorial staff.

    * = Required Field
    (if multiple authors, separate names by comma)
    Example: John Doe

    Related Content
    The Journal of Bone & Joint Surgery
    JBJS Case Connector
    Topic Collections
    Related Audio and Videos
    PubMed Articles
    Clinical Trials
    Readers of This Also Read...
    JBJS Jobs