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A Cost-Cutting Forum
Blog By: Bob J. Basile SR. RT
We in the cath lab have many challenges ahead with all the healthcare insurance changes facing us.
We must begin to think outside the box for ways to lower our cost of providing high quality healthcare, as well as to create a database of where every penny goes.
For instance, here’s one thought, involving the creation of a private buying group. We poll all interested parties to find out which widgets everyone buys and at what cost they buy the widgets for — then our buying group bulk buys these widgets at the lowest costs possible (much like Walmart).
The group 'member' then buys the widgets from the buying group for costs lower than they'd likely be able to buy on their own. This can be for items like wires, catheters, pacemakers, and more. (Again, just one thought!)
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Posted by admin on January 22, 2010 at 2:01 pm
I agree. The issue is one that requires a balance between having all the little toys you want and all the little toys you need. If you cut the list too short, you never learn about new devices that can make care safer, more efficient, or less costly. If everyone gets everything they want, there is no cost control and no buying advantage. From a performance standpoint in terms of measurable outcomes, for many balloons and some stents, the only measurable difference is the color of the device or the box it came in — oh, and THE COST, of course. Unfortunately, despite such a lack of objective data, some competing groups will line up on opposite sides of a choice and leave the hospital in the middle, unable to make an 80% or higher quota to realize a substantial price break for volume. This is not acceptable in the current envirorment. What to do about it, however, is a whole ‘nother topic.
— Jackson Thatcher, MD, FACC, FSCAI
(posted from a CLD board member discussion)
Posted by admin on January 22, 2010 at 2:01 pm
Cost analyses are a major factor. Uncovered 3 million dollars in 1981 when a crew of 3 did one on a cath lab system I was hired to straighten out. Revenue in 1980 was $239,000. Expenses were $237,000. 1984 expenses were $239,000. Revenue was 3.7 million. 100% recovery with chargeable items. Third-party carriers were paying 100% on 85% plans. I used the same principle when asked to set up a heart center in 1985. GPM was 61%. 47% of hospital operating revenue still comes out of the CCL operation to this day. It takes teamwork to make it happen. Products were all consigned with a 100% recovery. To do an extensive cost analysis takes a mean average of 6 months. How it was structured was never discussed with anyone because 90% of managers never fully understood the process and development. Would managers benefit from regionally based workshops on cost containment in cath labs?
— Chuck Williams, BS, RCSA, RPA/RA, RCIS, RT(R)(CV)(CI)
(Posted from a CLD board member discussion)
Posted by Anonymous on January 25, 2010 at 11:01 am
I like the idea. However, I believe there is a law against one facility disclosing its costs to another facility. It might be under the fair trade act, or something of that nature.
Posted by Anonymous on February 3, 2010 at 8:02 am
Bob, There are already buying groups like that out there. To list a few are, Assention, Healthtrust and Novation. Each facility hospital or group of hospitals buy into these groups to get the best pricing for just about everything a hospital uses. Great to bring this to the forefront. Each Cath Lab Director or Manager should check with their Materials Management Manager to get a listing of their buying group for a list of companies that they prefer that you use. Each buying group will get the hospital to agree to differentlevels of commitment. I.e. Tier 3 is access to the contract pricing with no commitment. Tier 2 is agreeing to purchase at least 50% of your product from them,and lastly, Tier 1 which may require the hospital to purchase 95-98% of product from that company. I hope this helps.
-Steve Gressmire R.T.(R)(CV)ARRT,AAMA
Senior Cardiac Catheterization Technologist
Cardiac Cath Lab
Gateway Medical Center
Clarksville, Tn
steve_gressmire@todaysgateway.com
Posted by Anonymous on February 10, 2010 at 3:02 pm
The feedback here is right on the mark. I believe a forum of hospital managers, physicians, and administrators could bring to light the cost of "needs" versus the cost of "wants".
How often do people come back from conferences with a wish-list? Always things that they "need". I submit, look into the physicians practices, and I suspect you will see that they operate on the lean side. Why? It comes from their pockets.
Perhaps a part of the answer lies in making all members of cath labs "team" members who buy into the process. Each dollar saved is posted and a percentage is given back to the staff and physicians.
Thoughts.
As the recession hammers us all, our patients are probably in similar is not worse conditions. Nationalized healthcare will mandate many changes, and those of us who have not yet started thinking out of the box will come face to face with the realities very soon.
Please, share your thoughts with us.
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