Financial Impact of a Dedicated Orthopaedic Traumatologist on a Private Group Practice

Objective: The purpose of the study was to demonstrate the financial impact of the addition of a dedicated orthopaedic traumatologist to a private group practice at a Level II community-based trauma system. Design: Retrospective review of financial records. Setting: Level II trauma center and large group practice. Methods: Office billing and financial data were evaluated for the 12 months before the addition of a dedicated, hospital-based, orthopaedic traumatologist and for a 2-year period after the hiring. Outcomes such as payor mix, collection rates, time to breakeven, days off, call days, evenings worked, durable medical equipment, and x-ray and casting reimbursement were analyzed. Results: The addition of a dedicated traumatologist was financially beneficial for the partnership. Existing practices increased 23% in charges and 32% in collections despite partners taking more vacation days and 14% less call. This was partially the result of increased nontrauma referrals, full clinic templates, and uninterrupted elective operating room schedules. Over a 2-year period, elective arthroplasty cases increased 13.1%, elective arthroscopy cases increased 35.4%, and total patient office visits increased 18.8%. The payor mix for trauma patients was poorer than the group average; however, this was offset by decreased overhead requirements. Collections rate for the trauma partner in evaluation and management, surgery, casting, durable medical equipment, and radiology improved dramatically after the first year to become just slightly less than other clinic-specialized practices. The cost of bringing on a new trauma partner is substantial but regained after 6 months. Conclusions: A dedicated orthopaedic traumatologist can be extremely beneficial to a group practice and to the traumatologist given the appropriate case volume, payor mix, and a relative value unit-based payment system.