DOING BUSINESS


transforaminal lumbar interbody fusion (TLIF) cages. Before you sign the final agreement, check it carefully. Did the supplier just add $500 (or more) to the “disposable TLIF kit” that is used with each TLIF cage and create additional expense that was not on your radar screen during your price negotiations? Even if implants are carved out and


fully reimbursed, the facility eats the full cost of disposables. Disposables can be as much as one-third of the sup- plier’s total charges on spine fusions. It is important to know how the cost and utilization of disposables relates to their respective implants. To get a complete cost estimate, ask your sales representa- tives what the total procedural costs— including disposables—are expected to be, then compare total procedure costs against your price targets, competitive quotes and payer contract terms.


Hiding Costs in Massive Price Lists The sheer size of a vendor price list, usually thousands of items, lends itself to intentional or unintentional hidden costs that can easily go undetected by materials managers. Unless you review every line item in a supplier-provided price list, hidden costs, like dispos- ables, can be present. Even if an ASC has established cap pricing on particular product categories, charges for “non-conforming” items could be added on top of those prices. For example, while it might look like all the items with a description of “anterior cervical plate” are at the desired price point, many other subcomponents—for example, set screws and caps—could be added into the surgery to make it a com- plete—and more expensive—implant construct. It is important to know which


{ THE AAAHC SURVEYOR }


Helping you raise the bar on patient care.


AAAHC surveyors live the same world you do because they’re providers, nurses, medical directors and administrators. It means your survey is collaborative, not prescriptive.


• AAAHC accredits more than 6,000 organizations.


• We’ve been helping organizations for more than 35 years.


• Our surveys are always conducted onsite – where it counts.


components go together to accurately understand procedure costs. Additionally, some items might be priced higher than the agreed-upon category pricing. Suppliers often take the liberty of deciding that some of the “premium” items in their price list do not fit into any of the ASC-prescribed pricing categories and, then, assign arbitrary prices to those items. Unless you closely examine every part number in each of your supplier’s price lists, it is likely that numerous inflated prices are hidden in those lists. Require sup- pliers to explicitly map each line item to your cap pricing categories and have them explain any non-conformances.


Leveraging Surgeon Relationships Some sales representatives try to gain the support of surgeons before approach- ing administration and/or materials man-


Improving health care quality through accreditation Contact us to learn more


847-853-6060 • info@aaahc.org • www.aaahc.org


ASC FOCUS APRIL 2016


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