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Emerging Market Opportunity: Musculoskeletal Services

John Kessler, for HealthLeaders Media, February 20, 2008
Editor's note: This is the first in a two-part series on the emerging market opportunity in musculoskeletal services. This week's article focuses on the factors driving the developing market. Next week's article will discuss how to prepare for key trends in the market and develop a program that will contribute to your bottom line.

Today, more than one-third (37 percent) of the U.S. population is 45 years of age or older. In a little more than 10 years that percentage is projected to increase from 37 percent to 42 percent, and account for more than 118 million people. By 2017, the leading edge of the baby boom will be entering their early 70's. This "never grow old, chase the dream" generation, which has reinvented every industry it has interacted with for more than thirty years, will seek healthcare services that promote good health and longevity, as well as support an active lifestyle. Chief among their needs will be musculoskeletal and orthopedic services.

A Growth Opportunity
Combine an aging population with technological advances in orthopedic care and devices, and the stage is set for unprecedented demand and increased opportunities for healthcare providers. Consider that the volume of musculoskeletal procedures increased by 24 percent between 1997 and 2005; spinal fusions increased by 73 percent, knee arthroplasties by 60 percent, and hip replacements by 32 percent. And, according to the Agency for Healthcare Research and Quality (AHRQ):

  • More than 3.4 million procedures were performed in U.S. hospitals in 2005, representing 8.6 percent of all hospital discharges.
  • Estimated expenditures for musculoskeletal procedures totaled $31.5 billion; more than 10 percent of total hospital revenues.
Over the next 10 to 20 years, we will see even more dramatic growth. The number of adults with arthritis (one of the leading drivers for musculoskeletal services) is expected to rise from 46 million in 2005 to 67 million by 2030. Physicians cited in a recent Journal of Bone and Joint Surgery article projected that primary and revision hip and knee arthoplasty procedures would double by 2030.

Several other factors also contribute to this developing market:

  • Improved screening and diagnostic imaging enables earlier patient identification, diagnosis and initiation of treatment for musculoskeletal conditions.
  • Today's rapidly evolving technology is resulting in higher-quality, more specialized medical devices and products that enable physicians and specialists to be able to recommend surgery as a proactive response rather than a last resort.
  • Direct-to-consumer advertising is also playing a role in providing consumers with an unprecedented amount of information on their conditions and medical treatment options. For example, medical device companies are bypassing surgeons and physicians and marketing new joint implants directly to consumers. The effect is that educated consumers are proactively approaching physicians and asking for medical services--and products--by name.
As a result, the median age for surgical interventions is dropping. While knee arthroplasty and hip replacements are performed typically in patients in their upper 60's, the mean age of spinal fusions was 52.

In these days of continuous revenue and margin challenges, musculoskeletal medicine can be--for those institutions with the will, fortitude and quality medical staff to pull it off--the next big growth opportunity. Next week we'll discuss the key trends in this market and what hospitals must do to take advantage of the opportunity.


John Kessler is vice president of The Strategy Group in Norfolk, VA. He is a consultant, speaker and author. He may be reached at kessler@thestrategygroup.com.
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