Increase in Physician Fees For Total Knee Replacements Due to Concentration in Orthopedic Markets

Health Affairs issued a study that said that there was a 7 percent increase in physician fees for total knee replacements due to the concentration of orthopedic groups.

According to the abstract, in the period 2001–10, the average professional fee for total knee arthroplasty was $2,537. During this time, in markets that moved from the bottom quartile of concentration to the top quartile, physician fees paid by private payers increased by $168 per procedure.

The increase nearly offset the $261 decline in fees that the authors observed, absent changes in market concentration.

Their findings suggest that caution should be used in implementing policies designed to encourage further group concentration, which could produce similar effects.

What does this mean to you, the employer? It means you are going to pay through the nose for knee surgeries as physician groups grow larger.

What does it mean to the workers’ comp industry? It means you are getting ripped off.

What does this mean for the medical travel industry? It means that you have to prove to US employers and carriers and insurance personnel that you really can save them money on knee surgery, and all other orthopedic surgeries.

Cosmetic, plastic, and other beautification surgeries are ok for some in the medical travel industry to offer, but to be really impactful, the industry must turn its attention to orthopedic surgery, as well as other medical services such as cancer treatment, heart surgery, etc.

That is when you will see increased volume in your businesses, that is when you will see increase numbers of patients, that is when medical travel will become possible for anyone who wants it, not just the well-to-do and those who want to look good.


I am willing to work with any broker, carrier, or employer interested in saving money on expensive surgeries, and to provide the best care for their injured workers or their client’s employees.

Call me for more information, next steps, or connection strategies at (561) 738-0458 or (561) 603-1685, cell. Email me at: Ask me any questions you may have on how to save money on expensive surgeries under workers’ comp. Connect with me on LinkedIn and follow my blog at: Share this article, or leave a comment below.


4 thoughts on “Increase in Physician Fees For Total Knee Replacements Due to Concentration in Orthopedic Markets

    1. Transforming Workers' Comp Post author


      No, it isn’t. It is already happening, so come into the 21st century and stop thinking that we have the best health care, because we don’t and other countries do. And will in the future. Or maybe you are afraid of losing your job, if it depends on perpetuating the padded cell our workers’ comp and general health care systems have become.

      Why don’t you do some research about Bumrungrad Hospital in Bangkok, the hospitals in India like Apollo and Wockhardt, and Fortis, as well as the hospitals in Central America that are equal to, or better than US hospitals. Check out CIMA Hospital in San Jose, Costa Rica.

      Don’t be stupid. American hospitals are too expensive.


  1. Elle

    If the cost is roughly $2500, how would the employer save money by having this done out of the country. Plane tickets alone would cost that much for an employee and guest, not to mention lodging. Even if the procedure was free, how would this save money using your example?


    1. Transforming Workers' Comp Post author


      The true cost of knee surgery is greater than $2500, more like $30,000 when all is said and done, not including hospital bill, here in the US. Costa Rica and other countries in Latin America can do it for far less, and airfare is not that expensive if done through a facilitator. They package everything for one price.

      Please do some research on medical travel, ie, tourism before dismissing it. It is already happening for plastic, reconstructive, weight-loss, dental and other procedures, so don’t tell me it can’t save money, because people and companies are already doing so.

      Read my blog, or read about HSM in NC, ICW in CA with SIMNSA in Mexico, and many others who have gone to India, Thailand, and elsewhere.



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