Include potential volume increase in cost evaluation
Include potential volume increase in cost evaluation
While all same-day surgery managers can pull together costs of equipment, supplies, and staff to determine the cost per procedure when considering a new technology purchase, there are some cost and reimbursement numbers that might not be as obvious, say experts interviewed by Same-Day Surgery.
Include costs of training staff if additional instruction will be necessary, says Vangie Dennis, RN, CNOR, advanced technology coordinator for Promina Gwinnett Health System in Lawrenceville, GA. Also include all supply costs, she adds.
Cost per procedure might drop
Look at any potential for volume increase in your evaluation, says Dennis. Sometimes, new technology increases the numbers of procedures your surgeons can perform. Increased volume can reduce the cost per procedure to the point that some expensive technologies become cost-effective, she explains.
A good example of an expensive technology that is profitable for her center is endometrial ablation for dysfunctional uterine bleeding, says Dennis. "We had three surgeons who were credentialed for endometrial ablations, and they performed about four ablations per month before the balloon was available," says Dennis. "Even though we now have a $650 disposable charge for each balloon ablation, we now have 45 physicians who are credentialed to use it, and we perform 10 to 12 ablations per month," she says. This increase in volume created a profitable service in less than two years, she adds.
How many references?
Look at how many patients are being referred to other facilities or surgeons who offer the technology you are considering, says Betty Bozzuto, RN, MBA, administrator of the Naugatuck Valley Surgical Center in Waterbury, CT. Those numbers will help you evaluate volume increases, she explains. "Your physicians or their office staffs can help you determine how many patients they are referring to other facilities."
Keep in mind that being able to advertise your facility as having the latest technology might give you a competitive edge in your market, says Bozzuto. "You may be able to attract new physicians, new patients, or new managed care contracts if you are a technology leader in your area."
As you evaluate costs, look at lease vs. purchase, suggests Dennis. "I evaluate the number and significance of changes in the technology within the past two years," she says. If there are a number of changes, Dennis opts to lease the equipment rather than invest in technology that will require update or replacement because it becomes obsolete. Lasers used for plastic surgery and dermatology are usually leased because they change so quickly, she points out. "Carbon dioxide lasers don’t change much, so we purchase them," she says.
Reimbursement for technology such as the uterine balloon ablation is difficult because it isn’t a new procedure, just a better way to perform an old procedure, says Bozzuto. While payers typically don’t want to change the amount they pay, you can ask for increased reimbursement at the time the new service is introduced. Also, address the issue at the time of contract renegotiation if you can demonstrate better patient outcomes, shortened recovery times, and increased patient satisfaction, she says.
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