Advertisement

A Preferred Vendor Model Reduces the Costs of Sports Medicine Surgery

Published:November 26, 2020DOI:https://doi.org/10.1016/j.arthro.2020.10.051

      Purpose

      To report on our institution’s first year of experience with a preferred vendor program for implants and disposables for sports medicine surgery.

      Methods

      Cost and utilization data for implants and disposables were analyzed for knee and shoulder sports medicine surgeries performed during the 2-year period including the 12 months preceding the start of the contract (contract year 0 [CY0] and the first 12 months of the contract period (CY1). The costs of grafts and biological therapies were excluded. Utilization of the preferred vendor’s products, operative time, and per-case costs were compared between the 2 time periods and adjusted for patient factors and case mix.

      Results

      Utilization of the preferred vendor’s shavers (0% to 94%, P < .001) and radiofrequency ablation wands (0% to 91%, P < .001) increased significantly in CY1 (n = 5,068 cases) compared with CY0 (n = 5,409 cases), with a small but significant increase in use of the preferred vendor’s implants (64% to 67%, P = .023). There was no significant difference in mean operative time between CY0 and CY1 (P = .485). Mean total per-case implant and disposable costs decreased by 12% (P < .001) in CY1 versus CY0.

      Conclusion

      Our institution was able to reduce the costs of sports medicine surgery with the implementation of a preferred single-vendor program for implants and disposables. This program had widespread surgeon adoption and did not have any detrimental effect on operating room efficiency.

      Level of Evidence

      III, retrospective comparative study
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Arthroscopy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Narvy S.J.
        • Ahluwalia A.
        • Vangsness C.T.
        Analysis of direct costs of outpatient arthroscopic rotator cuff repair.
        Am J Orthop (Belle Mead NJ). 2016; 45: E7-E11
        • Dickinson R.N.
        • Kuhn J.E.
        • Bergner J.L.
        • Rizzone K.H.
        A systematic review of cost-effective treatment of postoperative rotator cuff repairs.
        J Shoulder Elbow Surg. 2017; 26: 915-922
        • Elkousy H.
        • Gartsman G.M.
        • Edwards T.B.
        • Heaps B.
        • Laughlin M.S.
        • Press C.M.
        Financial impact of third-party reimbursement changes for CPT Code 29826: Experience of a large group practice.
        J Bone Joint Surg Am. 2014; 96: e183
        • Pauly M.V.
        • Burns L.R.
        Price transparency for medical devices.
        Heal Aff. 2008; 27: 1544-1553
        • Rohman L.
        • Hadi S.
        • Whitwell G.
        Surgeons’ knowledge about the costs of orthopaedic implants.
        J Orthop Surg (Hong Kong). 2014; 22: 221-223
        • Healy W.L.
        • Iorio R.
        • Lemos M.J.
        • et al.
        Single price/case price purchasing in orthopaedic surgery: Experience at the Lahey Clinic.
        J Bone Joint Surg Am. 2000; 82: 607-612
        • Okike K.
        • Pollak R.
        • O’Toole R.V.
        • Pollak A.N.
        “Red-Yellow-Green”: Effect of an initiative to guide surgeon choice of orthopaedic implants.
        J Bone Joint Surg Am. 2017; 99: e33
        • Farías-Kovac M.
        • Szubski C.R.
        • Hebeish M.
        • Klika A.K.
        • Mishra K.
        • Barsoum W.K.
        Effect of price capitation on implant selection for primary total hip and knee arthroplasty.
        J Arthroplasty. 2014; 29: 1345-1349
        • Bosco J.A.
        • Alvarado C.M.
        • Slover J.D.
        • Iorio R.
        • Hutzler L.H.
        Decreasing total joint implant costs and physician specific cost variation through negotiation.
        J Arthroplasty. 2014; 29: 678-680
        • Althausen P.L.
        • Lu M.
        • Thomas K.C.
        • Shannon S.F.
        • Biagi B.N.
        • Boyden E.M.
        Implant standardization for hemiarthroplasty: Implementation of a pricing matrix system at a level II community based trauma system.
        J Arthroplasty. 2014; 29: 781-785
        • Taylor B.
        • Fankhauser R.A.
        • Fowler T.
        Financial impact of a capitation matrix system on total knee and total hip arthroplasty.
        J Arthroplasty. 2009; 24: 783-788
        • Egol K.A.
        • Marcano A.I.
        • Lewis L.
        • Tejwani N.C.
        • McLaurin T.M.
        • Davidovitch R.I.
        Can the use of an evidence-based algorithm for the treatment of intertrochanteric fractures of the hip maintain quality at a reduced cost?.
        Bone Joint J. 2014; 96-B: 1192-1197
        • Wasterlain A.S.
        • Melamed E.
        • Bello R.
        • Karia R.
        • Capo J.T.
        Science of Variation Group. The effect of price on surgeons’ choice of implants: A randomized controlled survey.
        J Hand Surg Am. 2017; 42: 593-601.e6
        • Beredjiklian P.K.
        Shelf pricing for distal radius fracture implants.
        Clin Orthop Relat Res. 2017; 475: 595-596
        • Oren J.
        • Hutzler L.H.
        • Hunter T.
        • Errico T.
        • Zuckerman J.
        • Bosco J.
        Decreasing spine implant costs and inter-physician cost variation: The impact of programme of cost containment on implant expenditure in spinal surgery.
        Bone Joint J. 2015; 97-B: 1102-1105
        • Blackburn C.W.
        • Thompson N.R.
        • Tanenbaum J.E.
        • Passerallo A.J.
        • Mroz T.E.
        • Steinmetz M.P.
        Association of cost savings and surgical quality with single-vendor procurement for spinal implants.
        JAMA Netw Open. 2019; 2e1915567
        • Boylan M.R.
        • Chadda A.
        • Slover J.D.
        • Zuckerman J.D.
        • Iorio R.
        • Bosco J.A.
        Preferred single-vendor program for total joint arthroplasty implants: Surgeon adoption, outcomes, and cost savings.
        J Bone Joint Surg Am. 2019; 101: 1381-1387
        • Lee T.
        What is value in health care?.
        N Engl J Med. 2010; 363: 2481-2483
        • King J.S.
        • Pink M.M.
        • Jobe C.M.
        Assessment of reprocessed arthroscopic shaver blades.
        Arthroscopy. 2006; 22: 1046-1052
        • Kobayashi M.
        • Nakagawa Y.
        • Okamoto Y.
        • Nakamura S.
        • Nakamura T.
        Structural damage and chemical contaminants on reprocessed arthroscopic shaver blades.
        Am J Sports Med. 2009; 37: 266-273