In order to survive and thrive in today's environment, it is essential for ASCs to control the cost of implants in addition to handling more complex cases. To this end, facilities, physicians and group purchasing organizations (GPOs) must work together to find a way to control implant costs. These physician engagement opportunities coupled with other physician collaboration incentives, can significantly improve quality and reduce operational costs.
A new model: ASCs and outpatient procedures
As fee schedules are slashed, physicians will have a renewed interest in outside investments, such as joint ventures with ASCs. ASC investments provide physicians efficient use of their time, financial incentives and allow them to have oversight and input into the safe care of their patients.
Some of the new technology products that are highly physician choice – spine procedures, prostate procedures, colonography – are all procedures that were traditionally done at the hospital as an outpatient and are now moving towards the ASCs. For example, wrist fractures are very common in young and old alike, and a very high percentage of those are being done as an outpatient.
The spend on orthopedic implants and cardiovascular products is increasing at a much higher rate per year as far as dollar spend and as a percentage spend vs. medical/surgical. This highlights the need to put attention into the orthopedic and the cardiovascular product areas if those procedures are being done in your centers. Also, with current economic conditions demanding even more stringent pricing controls and suppliers willing to protect their bottom lines by being more willing to discuss "deals," now is the time to engage both physicians and suppliers in those product areas. Suppliers want, and are willing to lock in business for a longer length of time at more competitive prices, or they are willing to bid for an opportunity to gain market share.
Engaging the doctors
How do you get a doctor engaged? Relevant, actionable data is the basic building block for an organization's economic direction and also provides the facts and evidence needed to communicate the realities facing every stakeholder. Efficient value analysis processes will ensure that all bases are covered with regard to high-tech and high-touch healthcare products, including reimbursement, safety, education and clinical credentialing, product standardization and appropriate utilization. Once physicians see this type of data, and especially if they have a stake in the ownership of your facility, they will engage the suppliers in getting those costs lowered. What this also allows a facility to do is benchmark those costs versus a database that shows where they need to be with that particular supplier on a particular product. Also based on credible data, facilities can work to develop custom contracts based upon a surgeon's supplier choice and the quality outcomes they want to have for their patients.
In regard to overcoming physician loyalty to a particular brand, again, it involves a thorough value analysis process that looks at the risk assessment and quality of care. Evidence-based protocols must then be established in collaboration with physicians. Capitated rates need to be coordinated with protocols.
Facilities must also take a very aggressive role in prohibiting sales representatives from going into the surgery suite. If an ASC is really going to control cost and protect patients' privacy, suppliers should not be in the operating rooms.
In terms of physician incentives, ASCs that are owned or have a joint venture with physicians have a distinct advantage in incentivizing their physicians. In addition to their ownership models, as part of the collaborative implant reduction process, ASCs may want to consider engaging a company similar to Surgical Implant Services. This GPO is farmed as an LLC and is owned by the implanting physicians. The formation of this LLC legally provides physicians with ancillary income through negotiations of best in region pricing for implants.
Transparency in choices and reporting
The value analysis process must also include a tracking and outcomes evaluation component. Outcomes tracking by the value analysis team will evaluate clinician adherence to approved standardization programs, quantify the savings gains, build credibility by attending to any unforeseen issues, and establish a new baseline for the next initiative. Proactive tracking also allows the team to ensure that protocols are working properly and make adjustments if necessary.
Collaboration and cooperation will ensure physicians function as true owners of your ASCs, not as individual practitioners. Physician collaboration, in conjunction with a culture of employee ownership of processes, including the value analysis processes grounded in good business acumen, will assure your ASC is successful.
Learn more about Amerinet.