“Based upon our market and customer research, we believe
that U.S. healthcare providers are ready to support a simpler,
more transparent, fair-priced orthopedic business model,” Cardinal Health spokeswoman Lisa Ashby said when the deal was
announced in 2012.
Rhode agrees, though he warns that healthcare providers
must do more than merely support lower-priced implants. They
must be willing to manage the surgical procedure.
“This starts with being willing to take the representatives out
of the operating room and becoming an‘owner’versus a‘renter,’”
Rhode explains in his PHA Pulse article.“The hospital and surgery
center have been more than willing to allow the sales rep to show
up with the implants and instruments for the case. This saves on
implant inventory and instrument costs, but it comes at a price.
We have shown that this results in a 75-90 percent increase in
implant prices. This is why hospitals and surgery centers have to
become owners of the process and implants.”
Rhode recommends replacing the traditional sales rep with
an operating room device technician (ORDT), an on-site spe-
cialist qualified to teach and manage all stable implant ortho-
pedic procedures. Besides training surgical teams on implant
systems, ORDTs work directly with device manufacturers to re-
solve product availability/repair issues and handle complaints.
OrthoDirectUSA LLC, a Fort Wayne, Ind., consulting group that
developed an ORDT curriculum and training program, claims
the sales rep swap potentially could transform the orthopedic
Skeptics, however, are hesitant to ditch the full-court sales
press, fearing inadequate product knowledge from ORDTs and
quality issues among new, unproven companies, especially those
making subtle changes to well-known implants. Some surgeons
also are wary of using discounted products for complex joint
Ultimately, though, they may not have a choice. Rhode contends a soon-to-be bankrupt Medicare system will force a change
in delivery incentives, such as team-based care (partnerships
with primary care physicians, specialists, non-physicians and
hospitals). Quality outcomes and efficiencies increasingly will be
rewarded, and performance will take center stage.
“As reimbursements decline, ambulatory surgical centers (ASCs)
and acute-care facilities will have real difficulty trying to survive paying the current markup for stable technology implants. These products are quality, time-tested technologies that have exhausted their
patient value,” Rhode argues.“As soon as surgeons understand they
can have the same quality they are accustomed to, the transition to
generics will accelerate. Then, hospitals and ASCs can once again
become owners of the implants, the instruments and the process
that allows these savings.” ❖
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