1. Take advantage of a tight market. For a startup facility, one of the biggest capital equipment outlays would be endoscopes, and in today’s market, the three major manufacturers “Olympus, Pentax and Fujinon” are very competitive.
“Weve seen many new centers in the marketplace solicit multiple proposals for new equipment and maintenance contracts to ensure competitive pricing,” says Mr. Poisson. “The other factor to potentially take advantage of is that Olympus has a line of disposables that, if a center were to commit to an annual purchase level, certain discounts or credit toward future purchases or maintenance may be provided. As in the case of all clinical decisions, a focus on quality equipment that provides a safe environment for each patient is paramount “thankfully, all three equipment manufacturers have a proven track record in that regard.”
He notes that ASCs can also take advantage of the competitive market when renegotiating their contracts related to high-volume supply items. If a facility can agree to an annual purchase commitment, then a better discount may be obtained.
2. Set a shipping schedule. “Regardless of vendor, if your physicians can agree on a primary vendor for snares, biopsy forceps and the like, you may enjoy more favorable pricing and will be able to ask for drop-shipping at intervals over the course of the year, so you don’t have to store it all up front,” he says. “It’s something everyone ought to be considering. Deal directly with the vendor and work into the proposal a clause about drop-ship dates. They can always be moved based on inventory needs “it’s a great way to save, on average, another 10 to possibly 15 percent on supply costs.”
3. Upgrade by attrition. If you’re thinking of buying more scopes, the smartest thing to do is to add them gradually and to pay in cash.
“With well-trained and monitored technicians, the life cycle of a typical scope is in excess of six years, so it’s probably less expensive to purchase a scope up front than to buy using a ‘per-click’ type model,” says Mr. Poisson. “We also recommend that each facility have a comprehensive annual budget that includes equipment upgrades and replacement. After the second year of a center’s existence, you should begin adding one to three new scopes annually and buy them as a group of two or group of three, to get better pricing.
The downstream benefit is that, as scopes age out, they don’t do it all at once. However, once a scope reaches the limit of its life cycle it should be taken out of inventory and not utilized patient safety is paramount and using less than ideal scopes is to be avoided completely. The principal should be applied to other major capital expenditures as well, he notes: “After about the third year of operations, we begin replacing or upgrading about 15 percent of our IT back bone annually; printers wear out, PCs wear out or become outdated. It’s a good insurance policy against a major outlay.”
Mr. Poisson (jpoisson@endocenters.com) is executive vice president and strategic partnerships officer for Physicians Endoscopy, which develops and manages endoscopic ASCs in partnership with practicing GI physicians and hospitals. Read more about Physicians Endoscopy.