Impact of an integrated practice unit on the value of musculoskeletal care for uninsured and underinsured patients.

Background: Limited access to specialty care for uninsured and underinsured patients may be exacerbated by traditional fee-for-service approaches to care that incentivize volume and intensity of services over value of care. The purpose of this study was to determine the impact of a value-based integrated practice unit (IPU) on access to musculoskeletal care and surgical outcomes in a safety-net population.

Methods: A new IPU was implemented on 6/1/2016 at an established safety-net clinic providing musculoskeletal care in central Texas to supplement existing musculoskeletal care provided through a fee-for-service model.