for implants separately, and not all reimburse at rates that cover both the cost of the implant and procedure when payments are bundled. You will have to determine if the expense for the procedure is practical for your cen- ter to provide. “Second, maintain physician choice

when it is at, or below, your center’s determined cost threshold,” McMa- han continues. “When the threshold is exceeded, meet with your surgeons and standardize implant selection. If there are more than three surgeons utilizing more than one implant, it may be more difficult to come to a consensus but, for the sake of financial sensibility, it is worth it.”

Tips on Implant and Supply Management

Reduce costs, increase value, maintain choice BY SAHELY MUKERJI


nowledge is power when it comes to getting a good price on

implants, says Tim Burney, founder and chief executive officer of Advan- tien in Greenwood Village, Colorado. “You need to know the market and your alternatives,” he says. “Do not accept that you cannot get the same price as the hospitals. You can, believe me, you can.” For many

ASCs, purchasing

implants is somewhat like how people bought cars years ago, says James Bee, MD, chairman of the Orthopaedic and Spine Center of Southern Colorado. “There are ASCs that are paying more for implants and doing the equal vol- ume as another center that may be just down the street.”

List prices for implants available in

the market are usually at the top of the market, Bee says. “With this markup on the list price, vendors can offer a


certain percentage off list to make you feel like you are getting a good deal. If you are a freestanding ASC, you have no clue about the prices because you are not connected to a big management company or a hospital,” he says. “To determine a good price, you have to sit down with the price lists and compare costs. Who has time for that when you are managing a hundred other things in your surgery center?”

How to Get a Good Price Kelli McMahan, vice president of operations at Pinnacle III in Den- ver, Colorado, recommends a multi- step approach to get the best prices on implants. “First, a center needs to determine thresholds for implant expenses,” she says. “You have to be prudent and identify your third-party payer reim- bursement. Not all payers reimburse

When meeting with your sur- geons, present them with various vendor options, implant selections and costs. “Your physicians are key to lowering implant expenses,” she says. “You will have more leverage with implant vendors on costs when you have physician backing and are using more of the vendor’s products.” Convincing a surgeon to switch implants should be data-driven, says Thomas Eickmann, MD, president of Cornerstone Orthopedics in Wheat Ridge, Colorado. “Most surgeons are trained with a specific implant and their outcomes are influenced by that. But if you get your surgeon in a room, sit him or her down, show him or her the data and describe how switching an implant would improve the bottom line of your ASC, you will get your surgeon’s attention. Most surgeons are data-driven.”

It is incumbent upon the materials management person to make a case for an implant and present it to the surgeons, Burney says. “Educate the surgeons first. Tell them why a price is reasonable. If you convince the sur- geon, he or she will take a stand with the vendor and tell the vendor the price he or she will pay.”

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