Value-Based Health Care in Hand Surgery: Where Are We & Where Do We Go From Here?

David N. Bernstein, Ryan P. Calfee, Warren C. Hammert, Tamara D. Rozental, Mary L. Witkowski, Michael E. Porter

Research output: Contribution to journalReview articlepeer-review

2 Scopus citations


Health care delivery is broken. The cost of care continues to skyrocket and the outcomes most important to patients are often a mystery. Further, care is often delivered via a fee-for-service model where surgeons are rewarded for the quantity, not the quality, of services provided. Such a health care delivery system is not sustainable and does not incentivize stakeholders to focus on the most important element of the health care delivery “puzzle”: the patient. Fortunately, we are in the midst of transforming our health care delivery system, with a focus on optimizing the value of care delivery (ie, health outcomes achieved per dollar spent across a full care cycle). In hand surgery, progress has been made as part of this health system evolution. However, there remains much to accomplish. In this article, the authors review the 6 components of a strategic agenda for moving to a high-value health care delivery system for hand surgery, focusing on where we are today and where we need to go from here.

Original languageEnglish
Pages (from-to)999-1004
Number of pages6
JournalJournal of Hand Surgery
Issue number10
StatePublished - Oct 2022


  • Bundled payments
  • integrated practice units
  • outcome measurement
  • patient-reported outcome measures
  • value-based health care


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