Are repless models the answer to PPI cost management?
Medical device “repless” model
To reduce the cost of medical devices, particularly costly physician preference items (PPIs), some hospitals are contracting out or training their own staff to provide support in the operating room, replacing the role of a medical device sales representative.
Benefits
The primary benefit for a medical institution going repless is to curb the influence of sales rep upselling in the operating room and reduce the sales, general and administrative (SG&A) costs associated with having in-person rep support. Recent analyses suggests that repless models in Orthopedics and Spinal implant procedures can save up to 50% on the cost of medical devices.
In addition to reduced medical device costs, repless models also reduce patient privacy as few patients are aware of the sales rep presence in the operating room.
Challenges
With value segment in healthcare rapidly growing, ‘repless’ is becoming a common phrase as hospitals look for medical devices that are clinically effective at the lowest price.
However, in looking for the lowest price, hospitals will also need to balance the effectiveness and safety associated with these devices.
In addition, the lack of an expert from the medical device company could potentially impact patient safety if the hospital staff replacing the rep is not adequately trained on the supplier implant and instruments.
Furthermore, physicians who often had a preference for specific items, may be required to use items (sometimes generic) contracted by the hospital at a reduced price.
Finally, repless models lack the comfort and convenience of having a rep from the medical device supplier supporting the O.R. staff during the procedure. Some prominent Orthopedic surgeons have expressed their concerns as they feel the rep provides a security blanket and the model may only be applicable in outpatient settings such as ambulatory surgery centers with consistent OR staff requirements. Medical device companies also confirm the importance of having an expert from the supplier in the operating room. The concept has been considered disruptive to the status quo with much conversation on the topic on social media channels.
Examples
Innovative repless models are being championed by both medical device companies and hospitals.
On the medical device side, companies such as Smith & Nephew Syncera, Royal Oak Medical Devices, Microport Implant Partners and Cardinal Health Orthopedic Solutions have introduced repless models in order to offer low cost medical devices to hospitals.
On the hospital side, institutions such as Loma Linda University Medical Center and Mercy Hospital have implemented supply chain innovation solutions that include repless support that has accounted for up to 50% savings on Orthopedic and Spinal devices. Companies such as Intralign are helping hospitals accomplish this by employing RNs or PAs to take on the role of the rep.
Opportunities
It is clear that a new model will be required in a value-based healthcare environment. While repless models are an obvious answer to medical institutions, they will need to closely consider patient safety, total cost and outcomes across multiple specialities.
One opportunity to improve repless models is through innovative technologies. A technology-enabled medical device support model differs from a repless model by allowing heathcare professionals the ability to connect with medical device suppliers through a secure interface.
Technology-enabled medical device models
- Ensure the optimal team is present during a procedure by having an expert from the medical device supplier present for clinical or technical support
- Provide physicians the preference of selecting preferred suppliers
- Reduce hospital labor costs by eliminating the need to hire a PA or RN to replace the role of the rep in the operating room
- Scalable across multiple specialties and physician preference items, not limited to Orthopedic or Spinal procedures
Going completely repless can be a major jump for medical institutions to take. By enabling a technology-enabled support model, hospitals can still realize medical device cost savings, but still have the comfort and convenience of having an expert rep from the supplier supporting the OR staff.
Are you working in a repless institution or have a perspective on the repless topic? We’d love to hear from you.