Devices & Diagnostics, Hospitals, Policy

What does value mean for device industry in era of ACOs? Physician underscores outcomes at real-life bottom line

At a panel on moving from volume to value at Advamed 2013, Dr. Clifford Belden […]

At a panel on moving from volume to value at Advamed 2013, Dr. Clifford Belden of the Dartmouth-Hitchcock Medical Center gave an example of exactly what medical device company value means to accountable care organizations. He compared four devices the ACO considered (or is still considering) for purchase in 2013, then said which ones they paid for, and why.

“I think we all know the value equation. I think the quality piece is most tricky here,” Belden said. “Patient safety and outcomes are really gonna trump everything.”

The following are the devices the medical center considered, the decision, and the reasoning:

 

Device: MRI replacement

Decision: Quickly taken off list

Why? The replacement would cut patient appointments by five minutes, but ACOs don’t expect long lines and it’s a big investment. The current MRI machine they have is a “workhorse” and will continue to do the job.

 

Device: 3D Mammography

Decision: “That had no problem getting approved.” They purchased three tomosynthesis units off-cycle.

Why? It tends to have 20 to 40 percent fewer false positives, meaning less cost in the system and higher value for women patients. Plus, it finds more cancer. This was such a strong value proposition the devices are already installed and being used at the Medical Center today.

 

Device: MRI contrast

Decision: Still up in the air.

Why? More data is needed. Though it has a higher cost, it could be much safer; however, there haven’t been long-term studies. They’re on the fence.

 

Device: CT upgrade or replacement

Decision: It’s been put on the capital list and will be weighed with other priorities.

Why? The ACOs current CT is, like the MRI, a workhorse. “But the game changer here is the radiation dose.” The upgrade or replacement could cut it by up to 90 percent, which could lower radiation-associated cancer and lower cost in the system eventually. But the price tag is high.

 

For medical device companies, thinking about tangible outcomes like these–the bottom lines of budgets for ACOs–will be what makes the difference in their own sales. Coming up with a value proposition involves meeting real, sometimes urgent need.

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