MSKvalue Insights

The mandatory episode, in plain math.

For surgery-center administrators and MSK service-line leaders: what TEAM actually demands, what personalization actually returns, and where episodes are actually won.

Referral quality

The best surgical referral in 2027 is a documented failure.

Coverage for knee and hip replacement turns on documented, unsuccessful conservative care. The value-based MSK programs starting in 2027 manufacture exactly that record as a byproduct — and most centres are not set up to receive it. Plus the timing rule most people get backwards.

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Clinical AI

Medicare named a payment lane for clinical AI. It hasn’t priced it yet.

Six hundred pages into the same outpatient rule, Medicare gave algorithm-driven care a name — SaMS — made 2027 a bridge year, and asked the industry how to value it. The methodology is still a blank page. Comments close Aug 31.

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Policy

Physician-led evidence just got a foundation behind it

OREF and RegenMed launched MOTIV. What it validates — and the operator move it leaves open.

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Policy

CY2027: your surgeons take 7%, your facility gets 2.4%

Two proposed rules, one week apart, opposite directions. The asymmetry is structural — and the comment windows close Aug 31 and Sep 14.

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The big cycle

How MSK goes broke — the big cycle

Dalio’s four distress levers are all firing in musculoskeletal care at once — and the CY2027 rules show exactly where the money goes. Which side of the reorganization are you on?

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The ASM mandate

The ASM math: what ±9% of Part B in 2027 means for your surgeons

The Ambulatory Specialty Model is finalized, mandatory, and starts January 1, 2027 — and the low-back cohort pulls ortho, spine, neuro, and pain into peer scoring. The math, per NPI.

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Commercial models

Pay-per-procedure came for orthopaedics

The device was never the product — the procedure is. Why MedTech's commercial model is shifting to pay-per-case, and what the buy-side of that shift looks like for a center.

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Episode economics

Why your revision rate is your P&L

Under two-sided risk a revision stops being someone else's claim and becomes spend you eat. Better fit is the value lever — and the math is short.

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The 30-day window

The 30-day window: post-acute spend is now yours

TEAM prices SNF days, home health, and readmissions inside your episode. The least-instrumented setting in healthcare is now the biggest swing item on your score.

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Demand engine

Where your next personalized-surgery patients come from

The manufacturer locators dead-end patients searching for a personalized surgeon. That unmet, pre-qualified demand is an inbound funnel for the center that shows up.

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The mandate

TEAM is live. What a surgery-center administrator actually does about it

The episode model is mandatory, the 30-day window is scored, and the peer curve decides who keeps money. The administrator's concrete checklist.

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Episode economics

The per-case math of personalized surgery inside a mandatory episode

Under two-sided risk, better fit stops being a cost and becomes return the facility keeps. The arithmetic, stated plainly.

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The 30-day window

Your episode is won or lost at home

Discharge isn't the end of the episode — it's the midpoint. Why the home is the highest-leverage, least-instrumented part of the score.

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