Increasing Profitability in Orthopaedics

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3 ways image quality can help attract patients and referrals, and offset price erosion.

There are several strong forces in healthcare that are eroding profitability for orthopaedic providers in large hospital settings:

  • Price erosion as more surgeries – like knee and hip replacements – previously done only in the hospital move to outpatient settings.
  • The number of baby boomers – along with their aging joints – moving out of private insurance and onto Medicare and its lower reimbursement rates.
  • Steerage by some insurers to lower-priced providers.
  • More price sensitivity and comparison shopping by patients who have higher deductibles – and more awareness of competing providers, thanks to the Internet and the Price Transparency Rule issued by the Centers for Medicare and Medicaid (CMS).

What can you do to stay competitive and increase profitability in orthopaedics? According to the Advisory Board, “orthopaedic program sustainability now requires a shift in focus from revenue maximization and volume growth to patient acquisition and retention via cost competitiveness.” (1)

Image quality can help attract patients and referrals.

Quality image capture is an essential foundation of accurate medical diagnosis. Here are three ways it can help orthopaedic practices keep patients, attract referrals and offset price erosion.

1. High-quality imaging helps lower your downstream costs

In orthopaedics, quality image capture can mean the difference between making an accurate diagnosis the first time – or missing one of the many complex subtleties associated with musculoskeletal disorders. And making an accurate diagnosis the first time lowers your downstream costs. Wrists, feet and ankles have very complex anatomy. Minute MSK injuries, like scaphoid fractures, can be difficult to detect. In fact, failure to identify fractures is the most common diagnostic error in the Emergency Department, according to the World Journal of Radiology. (2)

High-quality images help your radiologists see more, to spot injuries they might have missed otherwise, and to make the right diagnosis the first time. This directly affects your bottom line by lowering downstream costs. According to Radiology Business, perceived suboptimal image quality led to about 11% of costly radiology callbacks. (3)

With today’s bundled and capitation payments, each return visit by the patient to get to the right diagnosis decreases your profits. Being able to make an accurate diagnosis from the initial image capture decreases the amount of repeat treatments needed by patients.

Leverage new developments in AI-driven image processing, like Smart Noise Cancellation. SNC software significantly reduces image noise while retaining fine spatial detail.

Controlling your downstream costs also helps you keep your costs to your patients in check – an important differentiator in this market of price sensitivity. Thanks to the Internet, patients are very aware that there are often multiple imaging providers within driving distance. With high deductibles, price sensitivity is weighing more heavily in their decision-making. Similarly, they are voicing their cost concerns to their referrers, who are perhaps also making note of lower-priced imaging providers.

There is yet another party monitoring the costs of imaging. Some health insurance providers are steering their members to facilities with lower-cost imaging services.

For these reasons, it is important to stay abreast of advances of image capture software, including those enabled by artificial intelligence (AI). Carestream’s AI-driven Smart Noise Cancellation (SNC) software significantly reduces image noise while retaining fine spatial detail (4) –there is no degradation of anatomical sharpness. When SNC is applied, it produces images that are significantly clearer than with standard processing. It also provides better contrast-to-noise ratio for images acquired at a broad range of exposures. We believe this technical breakthrough will be especially beneficial for the high-contrast detail necessary for MSK imaging. For example, in a bone exam it is important to visualize the trabecular bone pattern help rule out a fracture. With its ability to separate anatomical detail from noise, SNC can remove noise while maintaining the fine trabecular structure, easing the interpretation of the exam.

2. High-quality imaging can help increase capture rates in orthopaedics

A picture is not only worth a thousand words, it is also worth an increased capture rate. A quality image helps a patient understand their diagnosis better, and the need for surgery and treatment – increasing your capture rate. Dr. Anish R. Kadakia of Northwestern Memorial Hospital says he has a higher capture rate when patients can understand the image and the need for treatment.(5) And of course, a satisfied patient is likely to return to your hospital for future imaging and treatment needs.

Conversely, a dissatisfied patient – who was misdiagnosed initially – can negatively impact considerations by potential patients. Today, many online-savvy patients research imaging and other healthcare facilities before choosing a provider. The “patient experience” accounts for 5% of the ranking in U.S. News & World Report on “Best Hospitals.” Also, the Center for Medicare and Medicaid Services (CMS) surveys hospitals (with HCAHPS5) and uses those results as part of its Hospital Value-Based Purchasing Program. (6) In addition, radiologist and physician ratings are available via online platforms, including Rate MDs,, and yes, even Yelp.

Advances in the image capture process also can contribute to patient satisfaction. For example, capturing high-quality, long-length images of legs or spine can be difficult – especially with pediatric patients or patients with limited mobility who find it hard to remain still for an extended period of time. Carestream’s DRX-L Detector allows capture of long-length images with a single exposure. It enables a higher level of patient comfort, reduces patient dose, and helps decrease retakes – all factors that help increase patient satisfaction.

The DRX-L Detector allows capture of long-length images with a single exposure.

The DRX-L Detector allows capture of long-length images with a single exposure. 

3. High-quality imaging can help increase referrals

Quality imaging also can drive more referrals from physicians. Surprisingly, some referrers don’t realize there can be considerable variation in imaging quality. We recommend educating your referrers on the value of image quality and how it contributes to improved patient outcomes and satisfaction. Make them aware of your image capture software and equipment, and how it helps you take better care of their patients.

And don’t overlook the appeal of pristine image quality to your surgeons and radiologists. They want to work for a top-rated orthopaedic center that understands the value of high-quality imaging software. Don’t lose them to a practice that has better imaging tools.

Image capture software helps increase efficiency

Your choice of image capture software also can help increase productivity and throughput. For example, Carestream’s ImageView Software is designed to dramatically improve imaging efficiency by providing a common user interface across all Carestream image acquisition products, and fewer screen transitions for time savings and enhanced workflow. Other time-saving features available include leveraging existing protocols and applying custom preference looks. These small time savings can add up to accommodate more exams within the same time period.

I hope you found this blog informative. Please comment below on strategies you find effective for attracting patients and referrals in orthopaedics.

photo of the author, Katie Kilfoyle Remis
Katie Kilfoyle Remis is the Editor of Everything Rad, and is also Carestream’s Global Digital Media Manager.

Learn more:

  1. Quote was taken from the Advisory Board presentation “2020mOrthopedic Market Trends.” © 2020 by Advisory Board. All rights reserved. Carestream is a member of the Advisory Board Health Care IT Forum. Inclusion of this quote does not imply the Advisory Board’s support or endorsement of other content included in this publication.
  2. World Journal of Radiology Spectrum of diagnostic errors in radiology ( 
  3. Radiology Business,  The 4 most common reasons for imaging ‘callbacks’ in radiology (  
  4. Carestream Smart Noise Cancellation Technical Paper 
  5. Everything Rad: When to Use 2D Radiography vs 3D CT 
  6. Center for Medicare and Medicaid Services (CMS) surveys hospitals (with HCAHPS)


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