FEATURE There are at least 150 alternative

vendors for spine implants and maybe between 20 and 30 alternatives for gen- eral and sports orthopedic implants, whether from a well-known company or not, he says, and as far as clinical equivalency goes, they all meet the US Food and Drug Administration (FDA) requirements. “The surgeons don’t have time to

learn about all the alternatives,” he says. “That is why it is so important for the materials management person to understand the options out there. They need to educate themselves and their surgeons.” Third, McMahan says, once you succeed in convincing your surgeon, have him or her meet with your ven- dor. “Typically, orthopedic surgeons are interested in costs and reimburse- ments, especially, if they are inves- tors in the ASC,” she says. “I have a smaller center with two orthopods and they will do whatever it takes to obtain the best prices. They consistently ask if they need to talk to our current vendors to inquire about implant costs.” The surgeon is the best person to

talk to a vendor on behalf of an ASC to get the best price, Eickmann agrees. “Only a surgeon can tell the implant company what he or she is going to use in the next two years,” he says. “Have the surgeon sit at the table when talk- ing to the implant company and nego- tiate for you.”

At the meeting, “know what the

vendor is charging, educate him or her on your costs and your goals, then dis- cuss the price,” McMahan says. “Relay how many cases your ASC does per month and indicate where you need the price point to be. If the vendor does not meet your price, put it out for a bid.” At the end of the day, the vendors

will try to leverage the surgeon, Bur- ney says. “Most of the time, the ven- dors will come back with a counter offer that is reasonable,” he says.

educate themselves. “You can hire a group purchasing organization (GPO), but a GPO, by definition, takes bench- mark prices, averages them out and gives you that price,” he says. “Do not forget that GPOs are paid by the device companies.”

Data on pricing is available, Bur- “Be aware,” Eickmann says, “the

more you know about the implant companies that your surgeon likes to use, the bells and whistles and all the options, the better discussion you can have with them. They will give you a good price for something your surgeon will never use and a high price for what they will use. Make sure that they are giving you an all-inclusive price. Sometimes a vendor will give you a reasonable price for an implant but significantly increase the price of the cement, the saw blade or other acces- sory items.”

Investigating the Best Prices A lot of ASCs are losing hundreds and thousands of dollars on implants man- agement, Burney says. “The device companies are very good at selling their wares, so you have to go to them with a good understanding of the market.” A well-written contract is an impor- tant step to get a good price, he says. “The device companies write in new products that don’t fall under any of the categories listed which would have a certain percent off,” he says. “That is nonsense because there are very few innovative products; they often are revised versions of older products.” This is where an ASC needs experi- enced people to know the market or

ney says. “ASCs can go to benchmark- ing companies to buy data. Bench- mark pricing gives you an idea, but it gives a higher price,” he says. “If an ASC has a hospital partner, it needs to lean on the hospital for advice. The ASC can then ask its vendor how close it can come to that price.” It can be tough for an ASC to get a

good price on implants, Eickmann says. “In spite of not having the advantage of volume purchasing, ASCs can be very effective negotiating prices because of their better alignment with physicians.” If your ASC does not have the resources or support from leveraging entities, try to take advantage of assis- tance programs, such as an implant management service company, to obtain a reasonable price, McMahan suggests. “State associations are a great way to network with other cen- ters to find out how their facilities have decreased implant expenses.” Implant prices will become more critical to an ASC’s bottom line as certain companies go to bundled pay- ments, Bee says. “If you get a bundle and 80 percent of your bundle is taken up by your implant, you cannot per- form those cases,” he says. “Implant costs definitively affect your bottom line when it comes to bundled pay- ments. It has a ripple effect. Even though I am not an end consumer, as a consumer-customer of the implant company, I want to know I am getting a fair price. There is no published Kelly Bluebook for implant prices.”


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