Chawla SS, Whitson AJ, Schiffman CJ, et al. - This study was undertaken to ascertain patient-level drivers of lower costs and improved health-related quality of life (HRQoL) in two anatomic shoulder arthroplasty procedures – total shoulder arthroplasty (TSA) and ream-and-run arthroplasty. Researchers included 222 TSAs and 211 ream-and-run arthroplasties. They estimated the quality adjusted life years (QALYs) as a measure of HRQoL. Univariate and multivariate analyses were applied to ascertain factors significantly correlated with decreased hospitalization costs and improved HRQoL. The findings demonstrated that distinguishing factors correlated with reduced costs and elevated quality are becoming increasingly important in value-based care. This research distinguished fixed (gender, diagnosis) and modifiable (BMI) factors that drive reduced hospitalization costs and elevated HRQoL improvements in shoulder arthroplasty individuals. For both TSA and ream-and-run patients, higher preoperative patient optimism is a consistent predictor of improved HRQoL, and future research on optimizing the influence of patient expectations and optimism may be needed.