The financial case for single-use endoscopy

Single-use endoscopes are an alternative to traditional reusable devices that come without many of the drawbacks of the reusable devices. Against this backdrop, healthcare organizations are weighing the financial implications of shifting to single-use endoscopes.

During Becker's Hospital Review's 12th Annual Meeting, in a virtual session sponsored by Ambu, the world leader in single-use endoscopy, and moderated by Wes Scruggs, Ambu's vice president of corporate accounts, a panel of healthcare leaders discussed how single-use endoscopy can solve longstanding challenges while improving financial results. Panelists were:

  • Karen Conway, vice president, healthcare value, GHX
    Brian Howard, director, contract services, Vizient
    Karen Niven, director, performance groups, Premier
    India D. Randerson, vice president, strategic sourcing and procurement to payment, Henry Ford Health in Detroit

Four key takeaways were:

  1. Procedural backlogs, staffing shortages and infection risks create a favorable platform for single-use endoscopy. The time it takes to clean reusable endoscopes, the shortages of central sterilization technicians and the risks of infection and cross-contamination those devices carry pose burdens and liabilities that healthcare organizations are seeking to address. Single-use endoscopes represent an important opportunity.
  2. The total costs of reusable endoscopy are hard to quantify. When comparing the costs of reusable versus single-use endoscopy, operational leaders run into a math problem in calculating the total costs attributable to each. In addition to defined capital costs for acquiring the materials, reusable endoscopes have associated servicing costs for cleaning and sterilization and undefined costs associated with the risks of hospital-acquired infections and cross-contamination, while single-use endoscopes have costs associated with disposal.

"We need to turn the traditional cost analysis on its head. A true value analysis model needs to take into account the total cost of care and we truly have to look at the cost of infections, track the root causes and understand their frequency," Ms. Randerson said.

The cost of infections includes caregiver costs, missed revenue due to hospital beds occupied by patients with preventable infections and reimbursement penalties for readmissions. Ms. Randerson noted that because the cost of readmissions is easy to track, using that metric to build the business case for single-use endoscopes is easier than using the cost of infections.

  1. Single-use endoscopy fits into operational workflows in ways reusable endoscopy does not. The labor costs associated with cleaning, sterilizing and sometimes reprocessing inadequately cleaned reusable endoscopes have not only a financial component, but also an operational one. Because an endoscopy cannot proceed without that availability of sterilized materials and because many endoscopies take place on weekends, relying exclusively on reusable endoscopes creates bottlenecks that can limit the procedures performed (and the reimbursements eventually paid to providers).

"Having the opportunity to use a [disposable] scope and get the same quality of care, the same patient outcome, without having to call in that other portion of the staff to clean it or wait until they come back on Monday lends advantages," Ms. Niven said.

  1. Partnering with a single-use endoscope supplier adds up to more than purchasing materials. Such partnerships, which are available to health plans and providers, can be structured as value-based or performance-based contracts, where the manufacturer takes on risk based on real-world evidence of health outcomes achieved through the use of their single-use scopes. "The finances follow on that, so I think we're going to see real growth," Ms. Conway said.

Factors related to quality of care, labor and reimbursement all demonstrate the need for an updated approach to endoscopy. With single-use endoscopy shaping up as an option that ticks most or all of the boxes, operational and strategic purchasing leaders still need buy-in from doctors.
Then, Mr. Howard said, they need to take one more step: "Once you look at adoption, the conversation needs to go to a higher level and more importantly, go to finance."

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