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Hip and Knee Replacement at Yale New Haven Health System

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Yale School of Management
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Working with hospital system administrators, Dr. Mary O’Connor, the director of the Center for Musculoskeletal Care at Yale School of Medicine and Yale New Haven Hospital, looked to change the way hip and knee replacements (arthroplasty) were done in the Yale New Haven Health System. The team from the System fashioned a plan that coupled reduced vendor costs with quality improvements to provide a "triple win" – benefiting patients, surgeons, and the hospital system. Nonetheless, O’Connor’s plan had encountered resistance from a few surgeons who objected to the consolidated list of vendors at the center of the proposal.

Orthopaedic surgeons had always had free rein to choose the prosthetics they wanted at Yale New Haven Health System. When the Health System proposed to reduce costs by consolidating vendors, a couple of surgeons who were well respected in the hospital and the community expressed significant dissatisfaction about having to give up their preferred vendor. Physician dissatisfaction caused by a feeling of a hospital imposing mandates could have a significant political, cultural, and financial impact on the hospital itself. The fate of the plan rested with the leadership of the Yale New Haven Health System, who had to weigh the benefits of the plan versus the probability of alienating surgeons.

Published Date: 10/05/2017

Suggested Citation: Edieal Pinker and Jean Rosenthal, "Hip and Knee Replacement at Yale New Haven Health System: Negotiating a 'Triple Win' for Patients, Hospitals, and Surgeons," Yale SOM Case 17-010, May 10, 2017

Keywords: Affordable Care Act, Medicare, rehabilitation, incentives, bundled payments, fee for service, medical devices, orthopedic, Women in Leadership