And why PatientIQ is built for the moment.
For years, “value-based care” has been healthcare’s north star. Yet progress has been uneven. Many specialties still operate in a system where success is measured primarily by volume, utilization, and process compliance. At the same time, a different model is accelerating across the country. Outcomes are becoming the foundation of accountability, not only what was done, but what improved.
Orthopaedics is uniquely positioned to lead that shift.
Why orthopaedics? Because it sits at the intersection of high volume, measurable impact, and accelerating payment reform. From hip and knee replacements to sports medicine and spine care, orthopaedic care delivers some of the most tangible improvements in patients’ daily lives. Pain decreases. Function returns. Mobility improves. And those improvements can be measured clearly over time through validated patient-reported outcome measures.
That is why orthopaedics is increasingly becoming the proving ground for outcomes-first healthcare nationwide. As orthopaedics goes, the broader value-based care ecosystem will follow.
Healthcare has long struggled to measure what matters most to patients. Many quality programs focus on readmissions, complications, or process adherence. Those metrics matter, but they are not enough. Especially in musculoskeletal care, success is often defined by how a patient feels and how they function after treatment.
Patient-reported outcomes make that visible.
CMS has made this shift explicit through the Hospital-Level Total Hip Arthroplasty and Total Knee Arthroplasty Patient-Reported Outcome-Based Performance Measure (THA/TKA PRO-PM). The measure evaluates improvement in symptoms and functional status after hip and knee replacement using validated PROMs. In other words, it measures whether patients actually get better from their perspective.
This matters because it signals a national standard. Outcomes data is no longer a research-only effort or a differentiator for high-performing programs. It reflects the growing expectation that patient improvement can be measured, compared, and used to guide care.
For orthopaedics, that is a major advantage. Unlike many specialties where outcomes can be difficult to define or follow longitudinally, musculoskeletal care is uniquely measurable. Pain and function are both clinically meaningful and quantifiable, and they track directly to what patients value most.
Orthopaedics has been a testing ground for value-based payment models for nearly a decade. Bundled payments and episode accountability programs for joint replacement created early proof that aligning incentives around better recovery and fewer complications can reduce costs while maintaining quality.
CMS recently reported that the Comprehensive Care for Joint Replacement (CJR) model generated 112.7 million dollars in savings while maintaining quality for over 98,000 hip and knee replacement patients across 323 hospitals from 2021 to 2023.
Now CMS is expanding this approach with greater urgency through the Transforming Episode Accountability Model (TEAM). TEAM begins January 1, 2026, runs through December 31, 2030, and is mandatory for selected acute care hospitals. Lower extremity joint replacement is one of the core episodes included.
For orthopaedics, this is a defining moment. TEAM reinforces what the field already knows. Costs and outcomes are inseparable. If the goal is to improve value, the system must measure outcomes consistently, track recovery over time, and reduce variation across the episode of care. That is exactly what orthopaedics is positioned to do, and it is why orthopaedics is becoming the blueprint for outcomes-first healthcare.
Three characteristics make orthopaedics the ideal front door for outcomes-first care.
First, orthopaedic outcomes are measurable and meaningful. PROMs in musculoskeletal care are mature, validated, and tied directly to what patients care about. Improvements in pain and function are the outcomes that matter most, and orthopaedics can quantify that change. Measures like THA/TKA PRO-PM reflect the growing priority placed on patient improvement at the national level.
Second, the care journey is structured. Most orthopaedic patients move through predictable stages such as evaluation, prehab, surgery, rehab, and recovery. That structure makes it possible to capture outcomes at meaningful intervals, intervene early when progress stalls, and refine care pathways over time.
Third, orthopaedics is a national cost and volume driver. Hip and knee replacement remain among the most common and costly episodes in Medicare, which is why these procedures continue to anchor major CMS payment reform efforts such as CJR and TEAM.
Together, these forces place orthopaedics at the center of national transformation, not only because it can measure outcomes, but because orthopaedics can operationalize outcomes measurement in the real world.
For many organizations, the barrier to outcomes-first care is not belief. It is execution.
Collecting outcomes at scale is difficult without the right infrastructure. Many systems still rely on manual workflows or inconsistent point-of-care collection. Response rates drop when surveys are not delivered at the right time. Staff burden grows when outcomes collection is treated as an extra task rather than an integrated process. Data becomes fragmented, difficult to analyze, and hard to use for improvement.
CMS programs like THA/TKA PRO-PM and payment models like TEAM raise the stakes. Success is no longer defined only by reporting outcomes. It is defined by the ability to use outcomes to improve care, reduce variation, and perform under accountability models. TEAM also increases the need for longitudinal tracking by holding hospitals accountable for episode performance beyond the hospital stay.
PatientIQ exists for this exact moment in healthcare.
As outcomes measures and value-based payment models expand nationwide, orthopaedic organizations need infrastructure that makes outcomes measurement achievable across every patient and every pathway. PatientIQ helps organizations do that at scale by turning outcomes into an operational system, not a side project.
PatientIQ supports outcomes-first orthopaedics with capabilities that include:
Automated pathways that enroll patients and deliver surveys at the right moments
Workflow integration that minimizes administrative burden
Reporting and analytics that make results visible to clinicians and leaders
Benchmarking and collaboration so organizations can learn from peers and raise the standard nationally
This is what makes outcomes usable. Not simply collected, but organized into pathways, integrated into workflows, and translated into insights that drive improvement across the orthopaedic service line.
Most importantly, this infrastructure supports the real goal of outcomes-first healthcare. It helps care teams identify what works, spot variation, intervene earlier, and continuously improve patient recovery over time. That is the foundation of readiness for TEAM and long-term success as CMS continues shifting reimbursement toward measurable patient improvement.
Orthopaedics is proving something powerful. When outcomes are measured consistently, reported transparently, and tied to accountability, healthcare improves clinically and economically.
As CMS expands episode-based accountability through TEAM and outcomes measures like THA/TKA PRO-PM, orthopaedics will remain the leading edge of national transformation. But policy alone will not deliver outcomes-first healthcare. The shift will be powered by systems that make outcomes measurement practical and scalable for real clinical teams.
That is why orthopaedics will not just adapt to the outcomes-first future.
Orthopaedics will lead it.
And PatientIQ will be there, powering the data, workflows, and insights that move the entire healthcare ecosystem toward what matters most, patient outcomes.