Hospitals and integrated delivery networks rely on a wide range of medical devices to deliver safe and effective clinical care. The good news is that suppliers are continually launching new, innovative products to address patient needs. The challenge for supply chain leaders, however, is managing runaway costs for medical devices, while at the same time respecting physicians’ product preferences.
Becker’s Hospital Review recently spoke with two leaders from HealthTrust Purchasing Group: Anne Preston, assistant vice president, clinical contracting services, and Kelsey Duggan, PhD, senior director, medical device management. They discussed how analytics, in combination with physician education and alignment, are leading to more strategic and economical approaches to medical device procurement for healthcare organizations.
Note: Response have been edited for length and clarity.
Question: How can organizations use data to reduce unnecessary spend on medical devices and high-value implants?
Anne Preston: HealthTrust Purchasing Group uses data analytics in innovative ways to inform new medical device purchasing strategies. The first step is gathering purchase history data from the client’s purchase orders or invoices. We then run this data through our cleansing process, clinically categorize components at the SKU level, and analyze it for savings potential.
Benchmarking the organization’s data is key when developing strategies. We have access to thousands of implant data points that provide the intel needed to enhance savings. We can look at benchmarking from multiple perspectives, such as best-in-class, average and worst pricing, as well as by geography, number of beds, number of facilities and more.
Based on that analysis, HealthTrust presents a savings target and strategy recommendations to the IDN’s leaders and to the supply chain team. Our team leverages clinical expertise, leadership & physician alignment, and market dynamic. We work collaboratively with the leadership team to develop a customized medical device purchasing strategy. We never make any decisions in a vacuum. Our granular data analysis enables meaningful discussions with healthcare organizations, physicians and also the suppliers that HealthTrust negotiates with on behalf of our clients.
Kelsey Duggan: Once the client’s contracts are renegotiated and fair pricing is in play, HealthTrust partners with our members to develop customized, interactive analytics tools to illustrate the new medical device landscape at their facilities. The medical device purchasing data is enriched with additional information from EHRs. This may include patient demographic and procedural data, as well as any available information related to discharge, length of stay and readmissions. These tools then serve as the foundation for physician engagement and alignment conversations.
Combining purchasing and clinical information results in a more complete physician profile. Our goal is to identify procedures where high-value medical devices have been used, and then present information to physicians in a meaningful way. By incorporating patient and procedural information, we can have more accurate and fair discussions around variation in practice patterns related to medical device utilization. Our approach is never prescriptive to surgeons; it’s about transparency and partnership in making the best decisions for both patients and the organization.
Q: How do you achieve organizational alignment, including physician support?
KD: HealthTrust spends significant time on the front end to ensure the data shared with physicians is as accurate as possible. Our first conversation with surgeons is typically to educate them about HealthTrust’s process for acquiring, cleaning and enriching the data. We want physicians to trust the data and to trust us.
In subsequent conversations with physicians, transparent data reviews serve as the foundation for discussions related to implant utilization, financial and clinical variation, and best practices from evidence, research-based supplementary data. HealthTrust’s role is not to ask physicians to change their behaviors, but to help educate them about the financial impact of the medical devices they are currently using compared to their peers, and what other options are available. Physicians lead the conversation around what technologies they view as evolutionary versus revolutionary, and why they may choose one technology over another for different patient populations. This helps generate alignment between physicians and the organization’s medical device purchasing strategy.
Q: How does HealthTrust support hospitals in achieving medical device savings?
AP: HealthTrust’s collaborative, data-driven approach generates medical device savings for hospitals and IDNs in a few ways. A primary one is negotiating fair pricing. In some cases, organizations don’t realize they’re paying different prices to two suppliers for very similar products. Enforcing price parity across suppliers reduces unnecessary spending across hospitals in a buying group. When we take a deep dive into the data, we can easily see variation across suppliers and across hospitals.
We analyze information down to the SKU level, all the way to the device composition. It’s possible to see whether products are fabricated with metal or plastic, as well as any other special characteristics such as Vitamin E enhancements. This categorization process alone often highlights savings opportunities for organizations.
To keep your newly negotiated pricing working for you for the term of the agreement, the legal terms and conditions must be solid and enforceable. Our team has years of experience in negotiating with medical device companies. We provide support and guidance to help you avoid some common pitfalls that may lead to savings erosion.
KD: Greater physician awareness of the costs associated with medical devices can also help to generate savings. In some cases, surgeons may not have insight into the economic impact that their implant selection has on the organization. In partnership with our members, HealthTrust can share implant cost per case information with physicians for specific procedures and/or patient groups, and how that compares to their peers at both the local and national level. This process can facilitate alignment between physician behavior and the organization’s medical device purchasing strategy.
Matching the right implant with the right patient can also reduce medical device costs. For example, elderly patients with limited mobility may not need implants that are designed to withstand intense activity. “Low-demand” implants are a good fit for these individuals. They are high quality and have a proven record of good outcomes, but are typically less expensive than “high-demand” devices intended for younger, athletic patients. Our tools allow members and physicians to examine device utilization at the case-level, which allows for conversations around this type of patient-centered implant selection.
Q: How do you keep savings sustainable and avoid or reduce cost increases over time?
KD: The medical device industry is continually evolving. To sustain medical device savings over time, it’s essential for hospitals and IDNs to monitor, measure and manage their purchasing strategies on a regular basis.
To ensure that medical device purchasing strategies evolve with both the market and with organizational needs, HealthTrust meets with clients on a quarterly basis. Group meetings where peer-to-peer conversations occur among physicians tend to be the most productive. This way, HealthTrust and the hospital organization can ensure that the purchasing strategy remains relevant to the physicians' current and future practice patterns. For example, a technology that was once considered a ‘premium’ product, to be used only in rare cases, may become the standard of care over time as new evidence or indications are introduced.
AP: As existing medical devices become mature, new devices and technologies are also entering the market.HealthTrust routinely attends annual industry meetings like AAOS (American Academy of Orthopaedic Surgeons) and NASS (North American Spine Society), as well as cardiology symposia where new technologies are introduced. Our clients simply don’t have time to stay ahead of all the new medical device launches. We proactively find out what’s hitting the market and when, what the devices do, whether they are evolutionary or revolutionary and whether they deserve an upcharge. In some cases, a new device may not align with an organization’s device purchasing strategy and should be blocked. In other instances, new technologies may be appropriate for certain patient segments and we can determine what a fair price is.
To prevent savings from eroding over time, we have to be strategic, innovative and listen to our clients’ needs. If a client wants to be disruptive in the market, we encourage that. We consider all possible strategies to keep pricing sustainable.
Conclusion
Medical devices, and particularly high-value implants, can present significant savings opportunities for hospitals and IDNs. Successful purchasing strategies for these products, however, require more than simply renegotiating a supplier contract. Surgeon preferences for particular devices are an important aspect of the healthcare culture that can’t be overlooked.
Change management initiatives, such as data-driven physician education programs, can play a critical role in fostering buy-in for strategic purchasing programs. It is important to recognize that effective purchasing programs also require ongoing monitoring and updates. “What we’ve learned from our clients is that this process isn’t ‘one and done.’ You must track medical device purchasing strategies over time, celebrate wins and stay one step ahead of changes in the industry,” Duggan said.
a wide range of medical devices to deliver safe
and effective clinical care. The good news is that
suppliers are continually launching new, innovative products
to address patient needs. The challenge for supply chain
leaders, however, is managing runaway costs for medical
devices, while at the same time respecting physicians’
product preferences.