Value-based musculoskeletal care

Own the MSK episode.

Value-based accountability in orthopedics is no longer voluntary — it's federal policy. MSKvalue assembles best-of-class musculoskeletal care into one accountable episode: personalize the surgery, measure the outcome, get paid on the value.

For clinicians & ASCs → For patients →
One episode, assembled from best-of-class: custoMED.ai · AJRR · SurgeonValue · JointCoach
The mandate

Accountability isn't coming. It's here — and it's mandatory.

CMS has said the quiet part out loud: voluntary models let organizations opt in only when they can win. So the newest models are compulsory — and orthopedics is the tip of the spear.

Live now

TEAM

Mandatory joint-replacement bundle (2026, ~740 hospitals). Hip & knee episodes scored on cost, complications, readmissions, and patient-reported outcomes.

Finalized · 2027

ASM

Mandatory ambulatory specialty model — individual-clinician accountability on a peer-benchmarked cost curve. Low-back-pain arm pulls in orthopedic & neurosurgery.

Proposed

CJR-X

A nationwide expansion of joint-replacement bundled payment. The accountability model is widening, not retiring.

The reimbursement wall orthopedics has always fought is inverting into a tailwind — and MSKvalue is how you win the math.
The most cost-efficient TJR

The lowest-cost total joint replacement in America — by design.

A joint-replacement's cost isn't one number; it's four levers. MSKvalue pulls all four — and custoMED attacks the biggest one, the implant.

Lever 1 · Site

Right site of care

ASC, not hospital

Performing TJR in a surgery center runs 30–50% less than a hospital — roughly $10–20K saved per case, with lower 90-day admissions and ED visits too.

Lever 2 · Implant — the big one

Right implant cost

custoMED.ai — primary lever

The implant is ~50% of a TJR's total cost — the single largest line. custoMED's implant-agnostic, point-of-care personalization sidesteps premium OEM markups and weeks of lead time, at a fraction of the materials cost. This is the metric that moves the story.

Lever 3 · Alignment

Fewer revisions

personalized alignment

Revisions cost ~76% more than the primary — and infection revisions run tens of thousands. Personalized alignment lowers revision risk, so the savings compound over years.

Lever 4 · Recovery

Measured, at home

JointCoach + RTM

Camera-based recovery and remote monitoring cut readmissions inside the 30-day episode CMS now scores — protecting the bundle and adding RTM revenue.

Stack the four levers and the same operation costs a fraction — and lands on the right side of the mandatory episode. That's the MSKvalue TJR.
Demand · direct-to-consumer

The DTC funnel fills the low-cost pathway

arthritisrisk.com and jointclass.com run direct-to-consumer campaigns that screen and educate patients, then route them straight into the personalized, ASC-based, custoMED pathway — manufacturing demand for the exact episode that wins the math.

Why personalization wins

One-size-fits-all was always a compromise.

Standard implants and mechanical alignment force every patient's joint into a narrow set of shapes. Real anatomy doesn't work that way. Here is the case for personalization, made plainly.

Reason 1

Anatomy isn't average

No two knees, hips, or shoulders are the same. A plan and implant matched to the individual restores their own anatomy instead of averaging it away.

Reason 2

Fit drives satisfaction

Roughly one in five standard knee-replacement patients report they aren't fully satisfied — often tied to alignment and fit. Personalization is a direct answer to the residual-dissatisfaction problem.

Reason 3 · the value lever

Fewer revisions = money kept

Better fit targets lower revision risk — and revisions are the single biggest episode-cost driver (~76% more than the primary). Under mandatory two-sided risk, avoided revisions are savings the provider keeps.

Reason 4

Accessible, not boutique

Made in minutes on installed printers, implant-agnostic, at low capital. Personalization becomes the everyday standard, not a premium add-on for a few centers.

Honest framing: the high-level trial evidence on personalization is still maturing — which is exactly why the founding-surgeon model instruments every case and feeds the registry. The argument today is mechanistic, value-aligned, and patient-centered; the confirmatory data is what we build.

How a personalized joint is made

Scan to implant, in one guided workflow.

Personalization isn't a black box. Here is the exact path custoMED runs for every case — surgeon-approved at every step, never autonomous.

1 · Scan

Upload the imaging

A CT or scan is uploaded securely and anonymized. No new hardware, no workflow disruption — it connects to the imaging you already run.

2 · Reconstruct — the kinematic core

Rebuild the native center of rotation

The joint is segmented, and the patient's native center of rotation is reconstructed from the deformity-preserved compartment (the lateral side in a varus knee, the medial side in a valgus knee) — reading the answer off undamaged anatomy, not estimating on worn surfaces.

3 · Design

Plan, guide, and implant — for one patient

AI plus expert engineers design a patient-specific plan, cutting guide, and implant that replicates that center of rotation across the full range of motion. Implant-agnostic; fits the systems the surgeon already uses.

4 · Review

The surgeon approves

Everything passes through a surgeon-first viewer. The named surgeon reviews, adjusts, and approves the plan. Attested, never autonomous.

5 · Produce

Print-ready, in minutes

Point-of-care manufacturing on installed printers — not weeks of engineering lead time. In the surgeon's hands in hours.

6 · Operate & measure

Placed, then proven

The personalized implant goes in; recovery is measured with PROMs and remote monitoring and fed to the registry — closing the value-based episode.

The differentiator lives in step 2: reconstruct the native center of rotation from the healthy compartment, and replicate it through the whole arc of motion. That is what "personalized" should have meant all along.
The stack · best-of-class, assembled

One accountable episode — not a pile of point tools.

MSKvalue doesn't reinvent the wheel; it integrates the best product at each stage of the joint-care episode into a single, measured, reimbursable arc.

01 · Screen

Find the candidate

arthritisrisk.com

Free MSK risk screening turns a population into identified surgical candidates before they ever call.

02 · Educate

Prep the patient

jointclass.com

Evidence-based pre-op and post-op education that scales the "best-in-class" patient experience.

03 · Personalize

The right surgery, for one patient

custoMED.ai

AI personalized joint replacement — patient-specific plan, guide, and implant in minutes, implant-agnostic. ISO 13485 · FDA-cleared. custoMED →

04 · Measure

Registry-grade outcomes

AJRR + PROMs

Every case instrumented and benchmarked against the American Joint Replacement Registry — 4.6M procedures, the national standard the mandatory models score you on.

05 · Get paid

Capture the value

SurgeonValue.com

The AI practice OS — coding, prior auth, RTM, and 90-second AJRR abstraction — so the value you create is actually reimbursed. SurgeonValue →

06 · Recover

Prove the function

jointcoach.com

Camera-based recovery tracking that generates RTM-qualifying adherence and functional-outcome data — closing the episode loop. JointCoach →

How adoption actually happens

Personalization doesn't start in the OR. It starts on the web.

The path to a better joint now begins online — a symptom search, a free risk check, a night of reading — long before a patient ever chooses a surgeon. Whoever owns that digital front door routes the patient toward personalized care.

01

A patient searches

Knee or hip pain sends them online. A free joint check meets them there.

arthritisrisk.com
02

They learn personalization exists

Plain-language education shows a plan built for their body is possible.

jointclass.com
03

They decide, and find the surgeon

A calm guide routes them to a personalization-ready surgeon.

surgeryprocess.com
04 · the surgery

Personalized joint replacement

The demand arrives at the OR already asking for the personalized plan.

custoMED.ai
Adoption isn't only a sales problem you solve surgeon-by-surgeon — it's a demand problem you solve on the web. Own the digital front door and personalization becomes the thing patients ask for by name.
See the patient front door →
For clinicians & ASCs

Win the mandatory episode.

You're now accountable for cost, complications, and outcomes on every joint-replacement episode. MSKvalue is the operating system that lets you land on the right side of the peer curve.

  • Personalized surgery that lowers episode cost and revision risk
  • Registry-grade outcome capture (AJRR + PROMs) built in
  • The billing, RTM, and prior-auth layer so the value gets paid
  • ASC-ready economics — free to plan, pay-per-case, no capital wall
Request the clinician briefing →
For patients

Your joint replacement — personalized and measured.

A better joint replacement isn't a bigger hospital. It's a plan built for your anatomy, a team that measures how you actually recover, and care that stays with you from the first ache to full function.

1

Assess

A free check on your joint health.

arthritisrisk.com
2

Learn

Know what to expect, before & after.

jointclass.com
3

Personalized surgery

An implant & plan built for you.

custoMED.ai
4

Recover & measured

Guided recovery, tracked at home.

jointcoach.com
Start your surgery journey →
The episode economics

Personalization only wins when it's tied to the value.

Under mandatory two-sided risk, better alignment and fewer revisions stop being a cost and become a return the accountable provider keeps. Illustrative.

30-day
episode window CMS scores
4.6M
AJRR procedures to benchmark against
~$450
shared savings / case kept by the provider*
$147/mo
RTM revenue per recovering patient*