Most surgeons blind to implanted device costs

Few orthopedic surgeons know the cost of the devices they implant, according to a new study published this month in Health Affairs

Such physicians are expensive for the Medicare program overall, with implantable devices making up a large portion of those costs. While physicians are encouraged to consider cost of the devices, the study's authors points out, doing so is difficult.

For the study, the authors asked orthopedic attending physicians and residents at seven academic medical centers to approximate the costs of 13 commonly used orthopedic devices between December 2012 and March 2013. Among the 503 physicians who completed the survey:

  • Attending physicians estimated correct costs only 21 percent of the time; residents, 17 percent of the time
  • Thirty-six percent of physicians and 75 percent of residents rated their knowledge of device costs as "below average" or "poor"

Despite those figures, more than 80 percent of respondents said that cost should be "moderately," "very" or "extremely" important in device selection.

"Efforts to increase surgeons' knowledge of device costs would be much more successful in the absence of confidentiality clauses," the study's authors said. Medical device companies, the pointed out, regard pricing information as confidential, and in their contracts with hospitals, restrict listing cost.

Still, the authors said, perhaps the most important reason surgeons aren't aware of pricing is that most have no incentive to learn device costs as they don't directly affect either the care they provide to patients or reimbursement dollars received.

"Surgeons need increased access to information on the relative prices of devices and should be incentivized to participate in cost containment efforts," the study's authors said.

In one demonstration of a healthcare system's data-driven approach to reducing costs, Intermountain Healthcare is building an ambitious new data system to track the cost of every procedure, piece of equipment and supply its 22 hospitals and 185 clinics use.

The idea is to have data available so physicians and patients can discuss costs and outcomes before making treatment decisions.

Last January, a controversial 2.3 percent medical device tax went into effect as part of the 2010 Affordable Care Act.

To learn more:
- see the study's abstract

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