Content sponsored by OrthoIndy

In this week’s Thought Leadership roundtable, OrthoIndy CEO John Ryan and surgeon Dr. Edward Hellman talk about the importance of providing quality care where patients want it and at a price they can afford.

How do you plan to address the growing issue of health care affordability and accessibility, especially in the wake of new legislation in Indiana?

John Ryan: Access and affordability are growing issues that stand to worsen given rising labor and supply chain costs. The legislature, employers, providers, and payors will all need to play a role in better managing the cost of health care. Still, I don’t believe any one of us can wait for a global solution to begin solving the problem. While the legislative attempt to set a ceiling on hospital prices didn’t ultimately become law this year, we weren’t threatened by this prospect because we already provide some of the most affordable orthopedic care in the state, well below the proposed threshold.      

Lower expenses should translate into lower prices, and we continue to be very proactive in managing our expenses. We don’t build extravagant buildings, and we maintain a lean administrative team. This allows us to spend money on the things that matter most, like hiring top quality physicians and clinical staff.

Edward Hellman: We are forging partnerships with orthopedic providers across the state, and even nationally, to combat the rising trends in health care expenses. To this end, we recently announced a new partnership, PELTO Health Partners, which is a collaboration with the largest orthopedic providers in North Carolina and Washington, with the primary purpose of leveraging our scale to manage expenses more aggressively.

What emerging trends or best practices do you see for businesses looking to control health care costs while still attracting talent with competitive benefits?

John Ryan: OrthoIndy holds a unique position as both a health care provider and a major employer with 1,000 employees. So, while we collaborate with businesses like Eli Lilly and Cummins to pioneer innovative orthopedic care solutions tailored specifically for their organizations, we also strive to manage our own health care expenses. In my experience, the single best way businesses can control health care spend is by thoughtfully limiting the choice of providers in their employee health plans. This strategic approach motivates health care providers to offer highly competitive pricing with the prospect of increased work. But this also creates a challenging dilemma because employees typically want the freedom to choose their health care providers. Employers who achieve the greatest success in navigating this tension are those who preserve the provider choice employees want, while also incentivizing their people to select high-quality, cost-effective provider partners. Finding the right balance is crucial to effectively managing health care expenses while preserving employee satisfaction.

Edward Hellman: Direct-to-employer contracting has been an innovative solution for many local businesses in cities across the country. It provides that savings to the employer while keeping care close to home for their employees. We are uniquely positioned to provide that win-win of savings and access with locations circling Indianapolis that provide a full range of musculoskeletal care, including surgery and non-operative options.

The talent shortage is a challenge for the health care industry, too. How is OrthoIndy attracting and retaining top talent?

John Ryan: The talent shortage has had a significant impact on every aspect of health care in Indiana. Clinical roles such as nurses, radiology technicians, and medical assistants all remain in high demand and low supply. Great news if you’re a health care worker looking to make a move. But it’s also crucial to acknowledge that the labor shortage has placed tremendous pressure on clinical staffs, leading to burnout. Workplaces that adopt a “destination employer” mentality and prioritize the well-being and satisfaction of their team members—current and new—will be in the strongest position long-term to deliver a great patient experience and employee experience.

For our money, rather than getting into a bidding war over talent, we work to strike a thoughtful balance between competitive compensation and a fulfilling lifestyle.

Edward Hellman: Physician talent is also a vital consideration. Demographic projections indicate there will be increasing demand for orthopedic surgical services. It’s imperative that OrthoIndy recruit the next generation of talented orthopedic surgeons to meet this demand as well as to replace our retiring partners. Our model as an independent practice with ownership of ancillary income sources, such as our surgical facilities, has made us extremely attractive to young surgeons completing their surgical training. We have several new surgeons starting later this year and have additional applicants for consideration for next year. Their quality has been universally outstanding.

What other top challenges face the health care industry in Indiana, and how do you plan to address them in the coming years?

John Ryan: The greatest challenge in health care is undoubtedly the constant and unpredictable nature of change. From life-altering pandemics, labor and supply chain shortages, and the orthopedic needs of an aging population, to advancements that revolutionize repair and recovery, health care systems must remain ready and adaptable.

Anticipating and embracing the changes that lie ahead is essential for us, and for any health care system. Just imagine if we were still providing orthopedic care today using the same methods we used a quarter-century ago. We wouldn’t exist. We thrive today because of a forward-thinking mindset. That same agile approach must drive us to ensure our success over the next 20 years, leaning into the ever-shifting landscape of health care.

Edward Hellman: The pandemic has changed the way all businesses have to function. Health care, and especially surgery, remains primarily a face-to-face interaction. However, the back office and support services required to run our practice has changed dramatically. Many functions that used to require employees to be at their desk are now done remotely. We’re leveraging technology wherever possible to become more efficient and to keep our remote and hybrid team members connected to our onsite community and culture.

How will your practice continue to adapt to changing patient needs and expectations?

John Ryan: Patients crave convenience. And they expect on-demand orthopedic care. Gone are the days when patients had limited options for accessing care. Now, whether their orthopedic issue is chronic or has developed over time, they can easily schedule an appointment at one of our clinics. We strive to accommodate appointments within a day or two, ensuring a swift and seamless experience. For more urgent concerns like sports injuries or fractures, we have six Urgent Care centers ready to receive them for an experience that is fast, effective and way better than waiting in an ER for hours surrounded by every ailment imaginable. Trust me, as the dad of four, I've witnessed the convenience of OrthoIndy Urgent Care firsthand.

Edward Hellman: Access is such a huge issue and is part of why patients delay or skip the care they need. Patients want and need specialists closer to home. Most only want to drive 25 miles at most for orthopedic care. These factors have driven our expansion into vibrant communities like Greenwood, Center Grove, Brownsburg, Fishers, Carmel, Westfield, and most recently, Lafayette. There is also a growing national concern of access to quality care in rural communities. This plays a meaningful role in our expansions and partnerships as well, from our growing presence beyond central Indiana to moving our westside clinic and hospital closer to the highway.

How is your practice working to improve patient satisfaction and outcomes, and how do you measure success?

John Ryan: We place immense value on patient satisfaction, safety, and outcomes. While we hold ourselves to the highest standards, the judgment of our patients and independent third-party resources is what truly matters.

In 2023, we were honored to be named the No. 1 hospital in Indiana for patient safety in major orthopedic surgery and spine surgery. Additionally, we have received the prestigious Guardian of Excellence Award for 10 straight years, consistently scoring in the 95th percentile for patient satisfaction. We don’t take this recognition for granted—in fact it fuels our desire to continuously improve and exceed expectations.

Edward Hellman: You can’t improve what you don’t measure. So, we are constantly reviewing outcomes for individual diagnoses and surgical procedures. Our patients have probably noticed text messages or emails with links to surveys. These are validated patient outcome measures specific to the procedure that the patient has had or will have. By using these validated surveys, we can compare a patient’s health status before and after an intervention and can compare to local and national benchmarks. These surveys also drive our individual star ratings, which are shown in real-time on each physician’s profile, so patients can weigh that as they gather information.

What is the role of technology and innovation in improving health care delivery and outcomes?

John Ryan: Twenty years ago, a family member of mine had a total knee replacement surgery at OrthoIndy. Her recovery was typical of the era: three days in the hospital followed by additional time in a rehabilitation facility. Today, orthopedic surgeries have undergone an incredible evolution. Thanks to advancements in surgical techniques, medical devices and robotic-assisted surgery, most patients can now return home on the same day or the day after their surgery.

We strive to be at the forefront, embracing the latest advancements in our field. We are eagerly recruiting the next generation of orthopedic surgeons and medical staff who are being trained on the latest technologies and techniques in
our industry.

Edward Hellman: OrthoIndy has always been an early adopter of innovations, most notably our multiple options for computer- and robot-assisted surgery for joint replacement and advanced, minimally invasive spine surgery. While new technologies continue to come in at a rapid pace, we are always weighing trends versus meaningful advancements that will give the patient the best experience for a smooth surgery and faster recovery.

Patient safety drives our decision-making. For example, we’re the only health system in the state with the new EOS Edge imaging system. This allows us to obtain much more detailed images of the spine and extremities with much lower radiation doses to the patient. This can benefit any patient, but especially children with scoliosis who need regular scans to track the progression of their condition.

How are you collaborating with other health care providers, policymakers, and community organizations to improve the health of Indiana residents?

John Ryan: We are actively engaged in several organizations and forums dedicated to enhancing health care in Indiana, such as the Employer's Forum of Indiana and the Indiana Hospital Association, among others. All these organizations have the patients’ best interests in mind. But significant improvements in the health of Hoosiers will require a collective effort from all of us.

Edward Hellman: We are fortunate in Indiana to have a wealth of knowledge and resources in the health care industry. We are a founding member of the new Indiana Physicians Health Alliance, which is particularly focused on preserving the independent private practice of medicine, providing doctors an alternative to being employed by health system medical groups or physician practices acquired by private equity. Maintaining options in health care makes the entire ecosystem better, which ultimately benefits the patient.

How can health care systems balance growth with maintaining the highest level of care for their patients? Does OrthoIndy have a formula for success?

John Ryan: For as complicated as health care is, our formula is really simple: Hire high-quality physicians and clinical staff who love what they do, and who they do it for. If you can get this right, the rest tends to take care of itself.   

Edward Hellman: Great care starts with great people. You have to provide these talented teams an environment where they enjoy working and can do their best work. Take care of the caregivers, from the front desk to the back office.