The neurosurgery, orthopedic surgery, and otolaryngology – head and neck surgery (OHNS) departments at UCSF Medical Center in San Francisco had a 4% decrease in median surgical supply costs in six months through a price transparency initiative aimed at surgeons.
From January to June 2015, other services that were not participating in the initiative had a nearly 9% increase in median surgical supply costs, according to the study presented at the most recent annual meeting of the Congress of Neurological Surgeons. (To access an abstract of the unpublished study, go to http://bit.ly/1Ue7ee5.)
“To the best of our knowledge, there are no publications demon-strating cost reduction through a price transparency initiative directed at surgeons, and our work represents one of the first attempts to do this,” the authors said.
The premise for the study was that surgeons don’t know their OR costs. For example, the researchers say other research shows that orthopedic surgeons incorrectly estimate the cost of their devices, ranging from 1.8% of the actual price up to 24.6 times the actual price.1 The UCSF Medical Center initiative started with a survey of all attending surgeons, resident surgeons, and OR nurses in which they were questioned about their attitudes regarding cost and value. More than 95% of attendings, residents, and nurses agreed that surgeons can control costs, but only about half (56%) of attending surgeons were aware of ways to cut costs. About one in 10 (12%) attending surgeons knew how their procedure costs compared to their peers.
The researchers used data from electronic records to analyze the time and cost of all surgical procedures at UCSF over a two-year period.
Beginning in January 2015, the researchers gave “surgeon snapshots” with information about median surgical supply costs per case, as well as surgical preparation time and surgical procedure time, to surgeons in the neurosurgery, orthopedic, and OHNS departments at UCSF, said Corinna C. Zygourakis, MD, neurosurgery resident physician and fellow at UCSF’s Center for Healthcare Value. “These surgeons were compared to surgeons in the remainder of surgical departments at UCSF — cardiothoracic surgery, general surgery, OB-GYN, ophthalmology, urology, vascular surgery, pediatric surgery — who did not receive price transparency snapshots,” Zygourakis said in an interview with Same-Day Surgery. Each surgical department was eligible for a $50,000 reward, to be used for academic purposes only, if it met a 5% target cost reduction in 2015.
In the first six months, the researchers saw an overall 4% decrease in median case costs for neurosurgery, orthopedics, and OHNS, from $1,391 to $1,335 per case. Combined, the departments have saved more than $310,000 in the first six months of the intervention. The other surgical services had a nearly 9% increase in median case costs, from $704 to $766 over the same time period, Zygourakis said. The different departments have different median case costs at baseline, which is reflected in the difference of $1,391 for the neurosurgery, orthopedic, and OHNS departments versus $704 per case for all other surgical departments.
- Okike K, O’Toole RV, Pollak AN, et al. Survey finds few orthopedic surgeons know the costs of the devices they implant. Health Aff 2014; 33(1):103-109; doi: 10.1377/hlthaff.2013.0453.