Q: How often should spine surgeons renegotiate vendor contracts?Scott Blumenthal, MD, Texas Back Institute, Plano: Negotiating contracts with implant vendors is typically a responsibility the hospital handles however, as part of our partnership with the hospital we help provide direction on these decisions. In general we revisit our contracts on an annual basis.
Jaideep Chunduri, MD, Spine Surgeon, Beacon Orthopaedics & Sports Medicine, Cincinnati: Our surgery center staff are constantly looking at the costs of implants for certain procedures (in particular cervical spine surgery with allograft and a plate) and either eliminating companies or going back to them to tell them that they need to beat a certain price to get their implants into our system.
Dennis Crandall, MD, Founder and Medical Director of Sonoran Spine Center, Phoenix: My main hospital renegotiates vendor contracts every one to two years, depending on the pinch the hospital feels on their bottom line. Since vendors concede additional discounts every year, and since there [are] so many competitors in the spine implant space, I don't see this trend ending any time soon.
Adam Higman, Soyring Consulting: We often work closely with centers and facilities in material cost savings and contract negotiations and have done a lot of work in the spine contracts arena. Typically you will see negotiations happening every two to five years. Three years is the most typical contract term you will see. However, these time frames will become more flexible when savings are needed, with the introduction of new technology, or when new physicians with their own preferences are added to a practice.
Steven Lee, MD, Spine Surgeon, Muir Orthopaedic Specialists, Walnut Creek, Calif.: At one of our hospitals, a few surgeons (including myself) and hospital administrators have collaborated to form an "Orthopedic Surgery Technology Committee." We meet on a monthly basis to evaluate and discuss new technology, evidence-based guidelines, surgeon' preferences, and fair pricing for various implants. Major contract restructuring for general orthopedic and spinal implants have been undertaken in the past two years. In my recollection, this has been the first overhaul of implant pricing with distributors/manufacturers. Some of the main goals of the committee: to be good financial stewards of our resources (big picture: healthcare cost containment); critically evaluate new technology; make available the best new technology for the benefit of our patients.
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