“I’m fine” is one of the most expensive sentences in health care, because it can hide pain, lost function, fear, and stalled recovery. We talk with Dr. Judy Baumhauer, a national leader in orthopaedic surgery and outcomes measurement, about how patient-reported outcome measures (PROMs) give patients a real voice in their care and give clinicians a clearer signal about what’s working.

We get specific about PROMIS and why computer adaptive testing can measure physical function, pain interference, and even depression in just a few minutes, then trend those scores across an episode of care. Dr. Baumhauer explains how her team scaled PROMs from orthopaedics to a system-wide workflow, how results show up in the electronic health record, and why the numbers are most powerful when they spark a better conversation rather than replace one.

Then we zoom out to the future of value-based care in orthopaedics: CMS requirements, public reporting, bundled payments, and the risk of choosing the wrong instrument. We dig into why certain mandated surveys can blur pain and function, how comorbidities and ceiling effects can skew “improvement,” and why PROMIS crosswalks could help standardize reporting while lowering implementation costs.

If you care about patient-centered care, orthopaedic quality measurement, and where reimbursement is heading, subscribe, share this with a colleague, and leave a review with your take: should PROMIS become the default language for outcomes reporting?

The next wave in orthopaedic surgery isn’t just surgical technique it’s how care gets organized, measured, and paid for. We sit down with Dr. Aaron Chamberlain, senior medical director for Intermountain’s musculoskeletal clinical program, to unpack why vertically integrated healthcare systems can be a powerful engine for value-based care and what that means for surgeons who want to lead, not just react.

We talk candidly about “risk” and why taking on financial accountability can actually unlock better medicine: clearer incentives, tighter alignment with payers, and a sharper focus on outcomes across the full episode of care. Aaron shares how Intermountain uses deep data infrastructure, enterprise dashboards, and careful patient cohorting to reduce unwarranted variation and make cost and quality visible to clinicians. If you’ve ever wondered how an Epic-era analytics platform can change real-world practice patterns, you’ll hear the nuts and bolts.

You’ll also get a concrete care redesign example: shifting appropriate hand procedures from the hospital or surgery center into the clinic, then using shared savings to reward the extra work required to make the change safe and scalable. We connect that playbook to broader trends like bundled payments and the CMS TEAM model, and we close with leadership lessons that translate anywhere: keep physicians involved, stay close to the bedside, and “fall in love with the problem” before you pitch a solution.

If you found this useful, subscribe to the AOA Lessons in Leadership Podcast series, share the episode with a colleague, and leave a review with the value-based care question you’re wrestling with right now.

We sit down with Dr. Paul Anderson, a nationally recognized orthopaedic spine surgeon and longtime leader in bone health, to explain how bone fragility quietly drives pseudoarthrosis, hardware failure, periprosthetic fracture, and revision surgery across orthopaedics, including spine fusion, total hip and knee arthroplasty, shoulder procedures, and sports medicine repairs. Our goal is simple: help you make bone health optimization a normal part of elective surgical planning, not an extra task that never fits the schedule.

We start by clearing up a common trap: relying on a DEXA T-score alone. Dr. Anderson walks us through a more operational definition of clinical osteoporosis that combines bone mineral density, fragility fracture history, and the FRAX 10-year fracture risk calculator. That broader view catches the patients who “do not look osteoporotic” on paper but still have fragile bone and higher risk of poor outcomes after surgery.

From there, we lay out a step-by-step workflow you can actually run in clinic: who to screen, when to order DEXA, how to use imaging clues like CT Hounsfield units, and why orthopaedic surgeons should feel confident interpreting DEXA quality and results. We also cover how to build referral pathways using fracture liaison services, how to think about antiresorptive vs anabolic medications, and what timing looks like when you decide to delay surgery to improve bone strength.

If you want fewer failures, fewer fractures, and more predictable fixation, bone health has to be part of the plan. Subscribe and share this with a colleague.