NEWPORT BEACH, Calif. — By using certain implants and payers, costs can be regulated in orthopedic surgery, according to a presenter at the Interdisciplinary Conference on Orthopedic Value-Based Care.
New orthopedic technology is being introduced at a rapid rate and more complex cases of all types of surgery are being done, including spine surgery. This requires the use of more rods, screws and cages, according to Nitin N. Bhatia, MD, who is interim chair of orthopedics at University of California, Irvine. Therefore, Bhatia’s department decided to keep the costs low and value of care high through an implant standardization program.
Nitin N. Bhatia
“Implants continue to be a big cost driver,” Bhatia said.
The lessons his department learned from its effort to standardize the spine implants used “are probably translatable to all aspects, all subspecialties of orthopedics,” Bhatia said.
The standardization model has been successful by “limiting it to two or three vendors. The reason is, at that point, it is not just the benefit of looking at improvement in cost per implant and cost per surgery, but there are additional benefits to the hospital and surgeon that are somewhat intangible,” he said.
For example, decreased work for the hospital’s sterile processing department can result and surgeons gain familiarity with vendors and can rely on the implants and trays they need to always be stocked.
However, an implant standardization program should be done in a setting that respects surgeon choice and keeps them happy, Bhatia noted.
“Surgeons have to be able to do what they are comfortable with. If you are forcing them to do something they are not comfortable with, they are not going to have the outcomes that have led patients to seek them out,” he said.
Among the risks Bhatia discussed of such a program are the implant that is ultimately supplied is not what was expected, and surgeon choice becomes too limited. – by Susan M. Rapp
Bhatia NN. VBC in orthopedics: Physicians perspectives. Presented at: Interdisciplinary Conference on Orthopedic Value-Based Care; Feb. 9-11, 2018; Newport Beach, California.
Disclosure: Bhatia reports he receives IP royalties from, is a paid consultant for, is a paid presenter/speaker for and receives research support from Alphatec Spine; he receives IP royalties, is a paid consultant for, is a paid presenter/speaker for Biomet; is a paid consultant for and receives stock/stock options from DiFusion; he receives IP royalties, is a paid consultant for, is a paid presenter/speaker for and receives research support from SeaSpine; he is a paid consultant and a paid presenter/speaker for Spineart; he is a paid consultant for Zimmer; and he receives IP royalties from and is a paid consultant and presenter/speaker for Stryker.