Managing a shifting health care landscape by building more bridges — to D.C. and beyond

With a new presidential administration comes a renewed focus on health care reform and an opportunity, if not an obligation, for all stakeholders to participate in the process.

We are sure to see many proposals geared toward expanding health insurance coverage for more Americans and getting more for each health care dollar spent. One such proposal supported heavily by the Obama Administration, as evidenced by the $1.1 billion allocation in the $787 billion economic stimulus bill, is comparative effectiveness.

Recent language in a Senate report supports “a goal of developing an evidence base for consumers, clinicians, providers and policymakers regarding which health care interventions work best.” But many of us, including the government, surgeons, hospitals and even payers, share concerns that if appropriate safeguards and transparency are not put in place, comparative effectiveness may result in health care rationing, less coverage of medical technologies, and government-mandated clinical guidelines or treatment protocols.

Other initiatives under legislative consideration will also require cooperation among the stakeholders, including industry, government, hospitals, surgeons and payers to ensure the cost-effective delivery of health care without limiting access to necessary care or compromising quality. Many such initiatives will address quality and performance-related measures and can align incentives between providers, including the following examples.

Provider performance and quality measures

Implant registries — No one argues against the valuable role implant registries may play in providing additional information on device performance, survivorship and outcomes. The data accumulated through registries could also be important for evaluating the comparative effectiveness of treatments and devices. We must, however, work collaboratively with all the relevant stakeholders to ensure the registry is designed and managed to provide useful and accurate information. It is incumbent upon all of us to share information and insights with government so that comparative effectiveness does not become the first step toward rationing health care.

Infection control — Technologies that reduce hospital infections will be critical to the success of hospitals and, by extension, industry in the years to come. The Centers of Medicare and Medicaid Services will no longer reimburse hospitals for infection-related procedures if those infections were a result of hospital error.

If industry can continue to develop technologies to reduce the number of infections, we will have improved patient outcomes and reduced cost. Better infection controls will also help surgeons and hospitals address growing malpractice and insurance issues.

Improvements in efficience and resource consumption

System efficiencies — By now, most of us are familiar with the projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030, which were presented first at the American Academy of Orthopaedic Surgeons meeting in 2007, especially the data related to the number of orthopedic patients projected to enter the system. How will the system support many more patients with fewer surgeons while putting a greater emphasis on cost controls?

We believe that industry must continue to invest in research and development of products and processes that will optimize surgical efficiencies. Industry should also be a part of creating the metrics that demonstrate these short- and long-term cost efficiencies. New technologies that support surgical efficiencies will allow providers to appropriate resources and investments accordingly.

Working to keep value in our sights at all times

We call it Orthonomics at Stryker, but all industry players are focused on value and must continue to keep these efforts funded and moving forward. Government wants our help. Let?s be sure we?re all taking the necessary steps to provide it.

For more information:
Patrick Treacy is vice president of reconstructive marketing at Stryker Orthopaedics in Mahwah, N.J.