Understanding orthopaedic surgery industry alignment and financial relationships through the Sunshine Act

With increasing healthcare cost and changing demographics of the country, organisations such as the Centers for Medicare and Medicaid Services are implementing innovative programmes to improve the value of healthcare. These programmes require physician hospital alignment. To understand the amount of physican-industry alignment represented by industry provider payments, Medicare initialised the public release of Sunshine Act data in September 2013. The goal of this study was to 1) ascertain the industry-physician alignment by understanding the dollar amount and most common reasons for industry payments to orthopaedic subspecialists, and 2) ascertain which medical companies pay the largest sums of money to each orthopaedic subspecialty. The authors downloaded and analysed the publicly available sunshine data for the twelvemonth period from January–December 2015. Only orthopaedic surgeons were analysed, all other physicians were excluded. Adult reconstructive specialists had the highest amount of industry alignment as they received the highest mean total amount of payment ($2,769 ± 231) while paediatric specialists received the lowest ($479 ± 42). Across all subspecialties, food and beverage related costs contributed to the largest proportion of number of industry payments while travel and lodging related costs were unanimously the second most prevalent type of payment. Furthermore, the mean payment was highest for royalty or licensure. When involvement of each medical company to industry payments was assessed, the company Stryker was noted to be one of the top five payment contributors for all orthopaedic subspecialties. This paper illustrates that while adult reconstructive orthopaedic surgeons receive the highest mean total payments from industry, the most prevalent and highest paying types of financial relationships were relatively homogenous across the seven orthopaedic subspecialties analysed. Thus, all orthopaedic subspecialties had financial relationships with industry which promoted alignment. Furthermore, the top five industry players contributed to a significant portion of total number of financial relationships among all subspecialties, with Stryker being the most predominant company.