In an effort to control its medical device costs, Anthem Blue Cross of California has begun outsourcing its device purchasing to Access MediQuip, a Florida-based implantable device management company, for devices at about 40 sites in California.
The Surgery Center at NorthBay VacaValley in Vacaville, Calif., is one of the test sites. It is a three-OR, multispecialty ASC mainly used by three orthopedic surgeons and two podiatrists. Here Karen Faria, business director of the ASC, explains how the program works.
1. Access MediQuip's role. The company, which has focused on orthopedic implants, operates somewhat like a GPO, buying devices in bulk. Savings are shared with Anthem rather than with the facilities. The company also handles devices for most of the center's workers' comp cases.
2. Selection of implants. There are no limitations here. All major implants are available through the program.
3. Billing. The ASC sends in a request to Access MediQuip to participate in a case. The company either reimburses the vendor directly or reimburses the center upon receipt of the vendors bill. The insurance company is not involved.
4. Problems. The only problem occurs when the vendor doesn’t realize Access MediQuip is paying the bill and bills the ASC directly. Since the patient's name is not on the bill, the ASC has figure out the patient's identity, referencing the type of implant and the date of service.
5. Outcomes. Anthem is still weighing the project's results and has yet to decide whether it will be rolled out in the rest of California.
The arrangement may spread to Texas. Blue Cross Blue Shield of Texas has discussed partnering with Access MediQuip for a similar pilot project with Texas providers, according to Bobby Hillert, executive director of Texas Physician Hospitals Advocacy Center in Dallas. If the pilot is approved, he says it would be launched this fall.
Mr. HiIlert says there had been a similar project in Florida, using another device management company, but it was not as successful. "This program failed to take defaults and restocks into account," he says. "That made it a more difficult experience for ASCs."
Learn more about Access MediQuip.
The Surgery Center at NorthBay VacaValley in Vacaville, Calif., is one of the test sites. It is a three-OR, multispecialty ASC mainly used by three orthopedic surgeons and two podiatrists. Here Karen Faria, business director of the ASC, explains how the program works.
1. Access MediQuip's role. The company, which has focused on orthopedic implants, operates somewhat like a GPO, buying devices in bulk. Savings are shared with Anthem rather than with the facilities. The company also handles devices for most of the center's workers' comp cases.
2. Selection of implants. There are no limitations here. All major implants are available through the program.
3. Billing. The ASC sends in a request to Access MediQuip to participate in a case. The company either reimburses the vendor directly or reimburses the center upon receipt of the vendors bill. The insurance company is not involved.
4. Problems. The only problem occurs when the vendor doesn’t realize Access MediQuip is paying the bill and bills the ASC directly. Since the patient's name is not on the bill, the ASC has figure out the patient's identity, referencing the type of implant and the date of service.
5. Outcomes. Anthem is still weighing the project's results and has yet to decide whether it will be rolled out in the rest of California.
The arrangement may spread to Texas. Blue Cross Blue Shield of Texas has discussed partnering with Access MediQuip for a similar pilot project with Texas providers, according to Bobby Hillert, executive director of Texas Physician Hospitals Advocacy Center in Dallas. If the pilot is approved, he says it would be launched this fall.
Mr. HiIlert says there had been a similar project in Florida, using another device management company, but it was not as successful. "This program failed to take defaults and restocks into account," he says. "That made it a more difficult experience for ASCs."
Learn more about Access MediQuip.