Orthopedic organizations jointly announce creation of National Orthopaedic and Spine Alliance

The Cleveland Clinic, The CORE Institute, OrthoCarolina and The Rothman Institute have jointly announced the creation of the National Orthopaedic and Spine Alliance LLC, an orthopedic physician hospital organization that aims to network high-quality and high-value providers across the United States.

“[National Orthopaedic and Spine Alliance] NOSA will be first clinically integrated network of independent centers of excellence in orthopedic and spine surgery that have agreed to define and follow best practices, share clinical outcome data in addition to patient quality and safety data across a broad spectrum of procedures,” Joseph Iannotti, MD, PhD, chairman of the Cleveland Clinic Orthopaedic and Rheumatologic Institute and president of the National Orthopaedic & Spine Alliance, told Orthopedics Today. “The Alliance will provide value based clinical care for direct to employer and narrow network contracting for specific bundled payments for an episode of care for major reconstructive orthopedic and spine care. The Alliance will therefore allow access to the best clinical care at a more affordable cost to the employer and employee, under peer review best practices and documented measures of long-term outcomes.”


Joseph Iannotti

After an employer has joined NOSA, the Alliance will give the employees in need of orthopedic care a phone number where they will receive a “concierge-level service” regarding their treatment plan, including planning travel to and from centers. Follow-up care will be managed through evidence-based guidelines and NOSA will track the cost and quality outcomes for each patient.

Iannotti said employers will agree to a single contract to gain access to all providers, and other providers who want to join must conform to data sharing of outcomes and quality improvement.

NOSA plans to publish clinical outcome, patient safety and patient satisfaction data through annual outcome publications, similar to how the Cleveland Clinic publishes its outcomes, he said.

NOSA will have a board govern its actions in addition to three committees: a Quality Committee, Financing Committee and Nominating/Membership Committee. The board will be led by Iannotti, while the Quality Committee, Financing Committee and Nominating/Membership Committee will be run by Daniel Murrey, MD, MPP, CEO of OrthoCarolina, Mike West, CEO of the Rothman Institute and Jason Scalise, MD, vice chairman of the National Physician Integration of The CORE Institute, respectively.


Iannotti said the organization’s long-term goals include continuing to develop quality standards across providers as well as offering services to large self-funded employers directly and through other health care insurers interested in an integrated option for employees.

“We believe an integrated alliance of specialty centers managed and governed by physicians that are grounded by the principles of providing the best care for the best value with documented and publicly reported outcomes will become the standard to define how we can improve health care in the United States at an affordable price,” Iannotti told Orthopedics Today.


Iannotti is a paid employee of the Cleveland Clinic, but does not receive compensation for participation or leadership in the Alliance. All of the board members serve without compensation for their activities on the board.