How ASCs can manage implant costs: 3 leaders weigh in

At the Becker's ASC 21st Annual Meeting in Chicago on Oct. 24, three guest speakers from the ambulatory surgical center industry weighed in on managing the cost of implants.

Panelists included Natalie Soule, RN, CASC, administrator of Premier Orthopedic Surgery Center, Blaire Rhode, MD, founder of both Rhode Orthopedic Group Sports Medicine and Orland Park Orthopedics and David Kelman, vice president of technology and services at Syncera. The session was moderated by Lindsey Dunn, the editor in chief of Becker's Hospital Review.

 On choosing implants and comparing costs

Dr. Rhode: Primarily using stable implants, Dr. Rhode said he sees a profit margin of about 35 percent. "Oil companies make eight percent, so 35 percent is pretty good," he said. Physicians concerned with quality will not choose low-cost implants just to save their organization money, according to Dr. Rhode.

Ms. Soule: "It's not an administrator's or nurse's place to tell a physician what implant to use," said Ms. Soule. "But it is their place to educate [physicians] about prices and cost." The Premier Orthopedic Surgery Center has used the same implants for the last five years, according to Ms. Soule.

Mr. Kelman: "Slight modifications to implants can have bad results," said Mr. Kelman. This is why practices like Ms. Soule's avoid branching out to new products.

 On going "rep-less"

Mr. Kelman: "Rep-less" models are simply discounted implants, according to Mr. Kelman. Typically, implant sales representatives are in the operating room to demonstrate sets and advise nurses and physicians during procedures. Selling more standardized implants sans-representatives can considerably cut down the cost of implants.

Dr. Rhode: "God save the [hospital] patient without a sales rep," said Dr. Rhode, about total joint surgery at a hospital. From his point of view, hospital workers have more generalized training and need onsite technicians to help everything run smoothly. Given the amount of specialized expertise at his practice and implant business, Dr. Rhode does feel the need to use representatives.

Ms. Soule: "[Representatives] do make physicians happy, they do give a sense of security, but they do come with a cost," said Ms. Soule. The cost is accountability. Staff members do not learn the implant sets as well if vendors are always present, according to Ms. Soule. Nonetheless, representatives are used at her practice.

 Key Advice

Ms. Soule: Negotiate when prices go up. "It is a daily struggle; I don't think there's ever going to be one way to fix the cost of implants," said Ms. Soule. She also recommended knowing your contracts and keeping staff informed to stay on top of reimbursements.

Dr. Rhode: Align the physician with the cost of the implants. Dr. Rhode recommended incentivizing physicians to mind costs with schedule or monetary bonuses.

Mr. Kelman: He agreed it is important to align physicians with implant costs. Most importantly, the vendor is there to offer support, Mr. Kelman said.

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