In early February, Ortho Rhode Island began offering Stryker’s Mako SmartRobotics for reverse shoulder replacement procedures at the Ortho RI Surgery Center, becoming the first ASC in the state to do so.
Michael Bradley, MD, president and CEO of Ortho Rhode Island, told Becker’s the decision to bring the technology into the ASC came down to a data-driven process built around cost, time and margin.
“We know every cost. We know how much time everything takes. We know the margin. We know our average revenue is blended,” Dr. Bradley said. “We put those all together, and it creates basically a level playing field with every other procedure.”
That analysis becomes what Ortho RI calls a “margin per minute” assessment, a way to evaluate whether a new technology makes economic sense compared to other procedures performed at the center.
For Dr. Bradley, that data is essential for making high-cost technology decisions confidently.
“We feel pretty confident, and this is obviously not our first rodeo,” he said. “We’ve invested in technology; we believe in it. We’ve done this on multiple occasions. But I don’t know how you would do it without it.”
Dr. Bradley told Becker’s that when Ortho RI evaluates a robotics investment, the organization boils the decision down to three questions:
1. Does it make you better?
For Ortho RI, this means the technology enables something the ASC couldn’t reliably do before:provide a higher level of precision or capability that changes what is feasible in the ASC setting.
“That’s pretty rare in this day and age, but it does exist in some of these precision technologies, and robotics may fall into that camp,” Dr. Bradley said.
2. Does it make you faster?
Even if a tool adds cost, it may still make sense if it improves efficiency, especially when time is a key component of margin.
“If there’s a time element to the margin, are you implementing something that is making the case more efficient?” he said.
3. Does it save you money?
This outcome is less common, Dr. Bradley noted, but still worth measuring when evaluating supplies, contracts and standardization.
The team then layers in contract realities, including volume commitments and any per-case fees, to determine whether the procedure remains financially viable.
“On most deals, you have volume commitments. We know those like the back of our hand,” Dr. Bradley said. “There’s probably an associated fee per case that is added to it. We look at the efficiency of it, and if it’s still, at the end of the day, a valuable case to us, then it’s worthwhile to do that.”
Dr. Bradley said there can be “intangibles,” such as whether a technology draws more cases through word of mouth or marketing, but Ortho RI doesn’t rely on those factors because they’re harder to measure.
“I think all of those are possible,” he said. “I don’t know that we bank on any of that — that’s a little less measurable — so we still stick with the efficiency.”
