News | April 01, 2015

Variations in Use of Physician Preference Items Affect Patient Outcomes and Costs

Study finds medical devices going unused, physicians ordering devices that don’t match patient indications

April 1, 2015 — UHC has released the findings of a new study that evaluated the use of medical devices based on cost and quality outcomes. The goal of the study was to uncover several trends related to high-priced physician preference items (PPIs). Utilization of PPIs — which can account for 30 to 40 percent of a hospital's supply expenses — at 10 academic medical centers, focusing on procedures utilizing orthopedic implants, coronary and peripheral stents and cardiac valves.

The study, begun in 2013, integrated the pilot test of the UHC Supply Cost & Quality Tool, a business intelligence tool designed to help healthcare organizations identify variations in the use of medical devices and their links to costs and patient outcomes. The study identified the following trends:

  • "Custom" does not always mean quality: One organization identified a surgeon who routinely used a customized hip implant for patients undergoing standard, elective total hip replacement. The price tag for the customized implant alone was higher than the average Medicare reimbursement for the entire hospital stay. This physician's patients also had longer hospital stays, on average, and higher readmission rates than those of other physicians.
  • Hidden waste in unused devices: An analysis at one hospital showed that one of its physicians was wasting an average of $600 per hip implant procedure—six times more than other physicians at the hospital—as a result of opened but unused implants.
  • Not all devices match every patient: At one organization, physicians were consistently using hip implant components for older patients that were more advanced than those used for younger patients, counter to published research showing that standard components are more clinically appropriate for less-active patients. The costs of the advanced components were usually at least 25 percent higher than those of standard components.

 

"Our study reinforces that there is a clear need for healthcare organizations to have an integrated view of supply costs and patient outcomes in resource-intensive areas, such as orthopedic and cardiovascular care," said Mike Oinonen, senior director, CDI operations, product technology, UHC. "By leveraging data from UHC's supply chain and clinical databases, along with utilization data from their clinical systems, the study participants identified significant opportunities to reduce clinical variation, strengthen contract negotiations with suppliers, improve product selection and minimize product waste."

Following the pilot project, UHC released the Supply Cost & Quality Tool to its membership; UHC members that subscribe to the Clinical Data Base/Resource Manager and SpendLINK are eligible to participate in the tool. 

The case examples in the paper were derived from a very limited data sample from organizations that participated in the Supply Cost & Quality Tool pilot project. UHC plans to develop benchmark data while expanding into additional clinical areas as more participants use the tool.  

For more information: www.uhc.edu

Related Content

Videos | Radiology Business | August 02, 2019
Association for Medical Imaging Management (AHRA) President ...
Feature | Information Technology | July 31, 2019 | By Greg Freiherr
Innovation is trending toward improved efficiency — but not at the expense of patient safety, according to...
Demand for ultrasound scans at U.S. outpatient centers could grow by double digits over the next five years, according to a speaker at AHRA 2019. A variety of factors, however, could cause projections for this and other modalities to change. Graphic courtesy of Pixabay

Demand for ultrasound scans at U.S. outpatient centers could grow by double digits over the next five years, according to a speaker at AHRA 2019. A variety of factors, however, could cause projections for this and other modalities to change. Graphic courtesy of Pixabay

Feature | Radiology Imaging | July 29, 2019 | By Greg Freiherr
The coming years may be good for the medical imaging community in the United States. But they will not be easy.
Body language expert Traci Brown spoke at the AHRA 2019 meeting on how to identify when a person is not being honest by their body language. She said medical imaging department administrators can use this knowledge to help in hiring decisions and managing staff.

Body language expert Traci Brown spoke at the AHRA 2019 meeting on how to identify when a person is not being honest by their body language. She said medical imaging department administrators can use this knowledge to help in hiring decisions and managing staff. 

Feature | Radiology Business | July 23, 2019 | Greg Freiherr
Can you tell when someone is lying?
John Carrino, M.D., M.Ph., presents “Challenges and Opportunities for Radiology to Prove Value in Alternative Payment Models” at AHRA 2019

John Carrino, M.D., M.Ph., presents “Challenges and Opportunities for Radiology to Prove Value in Alternative Payment Models” at AHRA 2019. Photo by Greg Freiherr

Feature | Radiology Business | July 22, 2019 | By Greg Freiherr
Efforts to reform healthcare are booming, b
Radiology, medical imaging, is facing declining reimbursements, imaging departments continue to comprise a significant portion of the revenue stream in most healthcare organizations. Stewards of these departments are continuously looking for ways to optimize efficiency, increase patient and staff satisfaction, and lower costs without compromising the delivery of excellent patient care. Image by rawpixel from Pixabay

Image by rawpixel from Pixabay 

Feature | Radiology Business | July 18, 2019 | By Stefanie Manack and Judy Zakutny
Approximately 30 percent of a hospital or health system’s profit comes from imaging according, to...
CMS Proposes New Alternative Payment Model for Radiation Oncology
News | Radiation Oncology | July 17, 2019
The Centers for Medicare and Medicaid Services (CMS) issued a proposal for an advanced alternative payment model (APM)...