5 ASCs with effective purchasing strategies

Here are five ambulatory surgery centers with innovative and effective supply purchasing strategies.

If you would like to recommend another surgery center for this list, contact Anuja Vaidya at avaidya@beckershealthcare.com.  
 
DISC Sports & Spine Center (Marina del Rey, Calif.). Every new item purchased at DISC Sports & Spine Center must have COO Karen Reiter's approval. "We have a fairly strict process for ordering spine implants. Each request goes from the physician to the surgery scheduler and then to my desk, where and I verify the purchase price and that it's an implant for which we have already made an arrangement," said Ms. Reiter in a Becker's ASC Review article. "Then my tech emails the vendor to make sure they have it here."

DISC Sports & Spine Center also has a written policy to combat upselling in the operating room. Device reps are not able to upsell technology without approval from Ms. Reiter, and if they do, they're responsible for the cost. The surgery center, founded by Robert S. Bray Jr., MD, focuses on providing care for those suffering from sports injuries, orthopedic issues and spine disorders.

OA Centers for Orthopaedics, a division of Spectrum Medical Group (Portland, Maine). The surgery center created a sequential approach to source new instrumentation over several months. This approach allowed the center to evaluate and manage changes over time. This also made it easier to measure the impact on immediate-use steam sterilization (IUSS) rates and price comparison across vendors and medical equipment sources.

In 2011, the center had decided to actively improve sterile processing practices. In the same year, the Association of periOperative Registered Nurses issued additional guidelines around IUSS. OA agreed to adopt reducing IUSS to a recommended 10percent. This prompted the surgery center to evaluate its inventory of surgical instrumentation to determine where they could minimize IUSS. The group began by monitoring the types of instruments and trays that were being flashed, and this led to the development of smart scheduling. A working schedule program developed internally allows easy manipulation of case sequence to permit full reprocessing. A second tool developed during the process is an instrument tracking board that identifies which instrument trays are used in each operating room. All of the operating room staff are aware of the instrument work plan for the day. The practice did purchase additional instrumentation and have adopted an IUSS rate of 4 percent.

Founded in 1982, OA Centers for Orthopaedics provides comprehensive orthopedic care services, including surgical treatments for foot, ankle, hand, shoulder, knee, hip and spine conditions. It serves more than 60,000 patients annually and performs 3,000 surgical cases per year. There are more than 15 physicians practicing at The OA Center for Orthopaedics, and it is accredited by the Accreditation Association for Ambulatory Health Care.  

Polyclinic Surgery Center (Seattle). According to Joshua Billstein, a board member of the Washington Ambulatory Surgery Association and practice manager at The Polyclinic, a greatly underutilized strategy is networking with other administrators and talking about common problems, says Mr. Billstein.

"We had a tissue provider that went from being a local entity to being acquired by a national service group," he said in a Becker's ASC Review article. "So the prices went up. A number of my colleagues and I talked and they told be about some competing providers who I didn't know about. We were able to shift our business to a lower cost tissue provider."

The surgery center is Medicare-certified and offers surgical services in ENT, gastroenterology, general surgery, orthopedics, pediatrics, urology, plastic surgery and vascular surgery. It is a part of the Polyclinic, which includes more than 200 primary care and specialty physicians and advanced practice clinicians.  

Premier Orthopaedic Surgery Center (Nashville, Tenn.). Administrator Natalie Soule uses a group purchasing organization to leverage the best prices available for implants and always communicates to the physician about the price and reimbursement of the same-quality implant before approving a physician preference item purchase. However, she wants physicians to make the final decision.

"It is not our place to tell a physician whether they can or cannot use a particular type of implant or supply; however, if a physician requests an implant or supply that is not on contract, we would communicate to the physician the cost of the implant/supply, and my contract alternative," said Ms. Soule in a Becker's ASC Review article. "We strive to educate our physicians to the cost of implants and reimbursements."

The surgery center is affiliated with Premier Orthopaedics and Sports Medicine, which has more than 25 physicians. It offers treatments for conditions of the elbow, foot, ankle, hand, hip, knee, shoulder and spine. It also provides fracture care and osteoporosis services.

Texas Orthopedics Surgery Center (Austin). According to Luann Lamb, who manages supply and equipment orders at the surgery center, with fluctuating drug prices and availability, having three to four sources for pharmacy purchases saves money. Also, keeping a list of vendors and pricing for each drug gives ASCs a quick reference and they can move down the list and find the best price.

"Many times you see a large price difference between the different vendors. At one time we were ordering all of our drugs from one vendor. Having multiple sources can save us up to $1,000 on a weekly order," says Ms. Lamb.  

Also, using two group purchasing organizations with two different vendors has also saved the center a lot of money, and Ms. Lamb has found savings of more than $8,000 over a one-year period on supplies ordered every week.

"We use primary and secondary vendors for our implants so I know when I need to replace or add an instrument set, and I can usually go to my vendors and ask for a deal. I agree to purchase a number of implants up front and the vendor gives us the instrument set for free. I will only agree to this if I know we can use the implants within one quarter so I do not have product sitting on my shelf. We are not spending any more money than we would have and we add instrumentation to our inventory," she says.

Founded in 2002, the ASC is owned and operated by the physicians of Texas Orthopedics. It is fully accredited by The Joint Commission. Procedures commonly performed at the center include arthroscopy, knee arthroscopy, shoulder arthroscopy and endoscopic carpal tunnel surgery.  

More Articles on ASCs:

Dr. Daniel Eglinton Opens Asheville Biologics and Orthopedics
Who's Buying? 5 Statistics on ASC Acquisitions in 2010 vs. 2013
7 Things for ASC Leaders to Know for Thursday


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