This month's headlines
 

First-person look at your customers’ challenges. Turns out that healthcare providers – once considered “recession-proof” – are vulnerable to the economic downturn after all. But how vulnerable are they? Find out at the upcoming Annual Conference and Manufacturers Forum. CDC issues swine flu guidelines for hospitals. Concern about swine flu is sweeping the country, though indications are that the danger might not be as great as initially feared. Still, hospitals are being instructed to scrutinize patients and visitors for signs of the illness. Read about CDC’s guidelines. Being there. We’ve all been there: You or your reps are at a show. Your key customers are there. You man your booth faithfully. But when the education sessions begin, you and your reps duck out, working the phones or maybe grabbing a drink at the bar. It’s all good stuff, but one IMDA member believes it may be a huge missed opportunity. Groups within groups. Earlier this year, Oconee Medical Center in Seneca, S.C., made a decision that’s becoming more popular these days. Not only did the 160-bed hospital switch GPOs – from Amerinet to Premier – but it joined a subgroup within Premier called the WNC Health Network. Doors opening for natural orifice surgery. The term “minimally invasive surgery” is on the brink of climbing to new heights – or depths, as the case may be. Ethicon Endo-Surgery announced that it is the first company to receive an Investigational Device Exemption from the U.S. Food and Drug Administration to investigate devices specifically designed for natural orifice translumenal endoscopic surgery. Make healthcare cheaper…by making it better, Part 2. It’s time to tackle the big one – insurance, says IMDA keynote speaker Joe Flower. He offers a few ways to do just that.

2009 IMDA Annual Conference June 14-16, 2009 Francis Marion Hotel Charleston, SC

Annual Conference First-person look at your customers’ challenges

You’ve read about the effects the current economic recession is having on your hospital customers. Turns out that healthcare providers – once considered “recession-proof” – are vulnerable to the economic downturn after all. But how vulnerable are they? And how is that affecting specialty distributors and reps?

IMDA has asked Tommy Cockrell, senior vice president and COO of the South Carolina Hospital Association, to give a first-hand view of the economic crisis as it is affecting hospitals. He will do so at the upcoming Annual Conference and Manufacturers Forum, June 14-16 in Charleston, S.C.

IMDA Announcement Vendor credentialing recommendations In March 2009, IMDA and a number of other supplier and provider organizations developed and sent to the Joint Commission a set of recommended standards regarding credentialing criteria for clinical sales reps, that is, reps who find themselves in the immediate vicinity of patient care, such as the OR or cath lab. IMDA members are urged to view the recommended standards and share them with their customers. The recommended standards can be found on the IMDA Website at www.imda.org. Click on the “vendor credentialing” box.

Cockrell understands the business of healthcare delivery. Prior to joining the South Carolina Hospital Association, he was employed with Kershaw County Memorial Hospital (now Kershaw County Medical Center), Camden, S.C., for 21 years, most recently as chief financial officer. He is an active member of the Healthcare Financial Management Association and has served as president of the South Carolina Chapter of HFMA.

Conference attendees can expect Cockrell to tackle the tough topics facing their hospital customers today, including the impact of the recession on providers’ margins, access to capital and investment income. IMDA members will be able to ask Cockrell how the recession is affecting charity care and elective procedures, and how the American Recovery and Reinvestment Act (the “economic stimulus plan”) will affect providers.

Cockrell is just one of many dynamic, informative speakers who will be on hand at the Conference. Additional education sessions will include:

• “Selling into a value-based healthcare system,” by Joe Flower, healthcare speaker, writer and consultant. While most people are talking “crisis,” Flower talks about “opportunity” and how medical companies can find it in today’s environment.

• “Update on vendor credentialing,” by IMDA President Shawn Walker, who has worked with a number of other organizations (including AdvaMed, the Medical Device Manufacturers Association, Association of periOperative Registered Nurses and the Association for Healthcare Resource and Materials Management) to draw up a consensus statement on the topic for the Joint Commission.

In addition, the Conference will feature breakout sessions on a number of topics, including virtual prospecting, sales rep compensation and IMDA’s proposed code of ethics.

IMDA members who register before May 15 will receive the early-bird discount – a $100 value. Call IMDA at (866) IMDA-YES or visit the Website at www.imda.org. Non-members can attend as well. Call IMDA to learn about a special offering being extended to non-members.

Also, make your hotel reservations now with the historic and comfortable Francis Marion Hotel. The special IMDA room rate is guaranteed only until May 13. After that date, reservations may be made at the group rate based upon availability. Call the hotel directly at (877) 756-2121 or (843) 722-0600.

Return to top

IConcern about swine flu is sweeping the country, though indications are that the danger might not be as great as initially feared. Still, hospitals are being instructed to scrutinize patients and visitors for signs of the illness.

On April 29, the Centers for Disease Control and Prevention released “Interim Guidance for Infection Control for Care of Patients with Confirmed or Suspected Swine Influenza A (H1N1) Virus Infection in a Healthcare Setting.” IMDA members interested in taking a look should visit http://www.cdc.gov/h1n1flu/guidelines_infection_control.htm. Some of the highlights:

IMDA Announcement Refer a member and get $50 Every time IMDA gains a member, our collective voice grows louder, our collective wisdom becomes greater, and our collective influence in the market grows. It's good for everyone. And there's no better source for new members than current ones. After all, you know the market, you know the people. That's why IMDA is offering members $50 for every new member who joins as a result of your referral. So when you're walking the floor at your next trade show, or taking a break at your next sales meeting, keep an eye out for companies that might benefit by joining IMDA. Collect business cards and send them to headquarters. Fifty bucks is nice. But the added wisdom, knowledge and camaraderie that a new member brings are even greater payoffs.

1. Healthcare facilities should establish mechanisms to screen patients for signs and symptoms of febrile respiratory illness who are presenting to any point of entry to the facility for care or making appointments to be seen at the facility. Provisions should be made to allow for prompt segregation and assessment of symptomatic patients.

2. Any patients who are confirmed, probable or suspected cases and present for care at a healthcare facility should be placed directly into individual rooms with the door kept closed.

3. Procedures that are likely to generate aerosols (e.g., bronchoscopy, elective intubation, suctioning, administering nebulized medications) should be performed in a location with negative pressure air handling, whenever feasible. An airborne infection isolation room with negative pressure air handling with 6 to 12 air changes per hour can be used. Air can be exhausted directly outside or be recirculated after filtration by a high efficiency particulate air (HEPA) filter.

4. Procedures for transport of patients in isolation precautions should be followed. Facilities should also ensure that plans are in place to communicate information about suspected cases that are transferred to other departments in the facility (e.g., radiology, laboratory) and other facilities. The ill person should wear a surgical mask to contain secretions when outside the patient room, and should be encouraged to perform hand hygiene frequently.

5. Healthcare personnel who enter the rooms of patients in isolation for swine influenza should wear a fit-tested disposable N95 respirator or equivalent (e.g., powered air purifying respirator). Respiratory protection should be donned upon room entry. Note that this recommendation differs from current infection control guidance for seasonal influenza, which recommends that healthcare personnel wear surgical masks for patient care. The rationale for the use of respiratory protection is that a more conservative approach is needed until more is known about the specific transmission characteristics of this new virus.

6. Visitors may be offered a gown, gloves, eye protection, and respiratory protection (i.e., N95 respirator), and should be instructed by healthcare personnel on their use before entering the patient’s room.

7. Isolation precautions should be continued for seven days from symptom onset or until the resolution of symptoms, whichever is longer. Persons with H1N1 virus infection should be considered potentially contagious from one day before to seven days following illness onset. Persons who continue to be ill longer than seven days after illness onset should be considered potentially contagious until symptoms have resolved. Children, especially younger children, might be contagious for longer periods.

8. In communities where H1N1 virus transmission is occurring, healthcare personnel should be monitored daily for signs and symptoms of febrile respiratory illness. Healthcare personnel who develop these symptoms should be instructed not to report to work, or if at work, should cease patient care activities and notify their supervisor and infection control personnel

9. Facilities should have signage at entry points instructing patients and visitors about hospital policies, including the need to notify staff immediately if they have signs and symptoms of febrile respiratory illness. Facilities in communities where swine influenza transmission is occurring should limit points of entry to the facility.

Return to top

IWe’ve all been there: You or your reps are at a show. Your key customers are there. You man your booth faithfully. But when the education sessions begin, you and your reps duck out, working the phones or maybe grabbing a drink at the bar. It’s all good stuff, but one IMDA member believes it may be a huge missed opportunity.

IMDA Announcement Door Opener If your reps call on the OR, you know the drill: They have to demonstrate their knowledge of OR protocol, HIPAA, bloodborne-pathogen regulations and more. Today, with vendor credentialing in the mix, the barriers to entry into the OR are higher than ever. Help your reps pass through those barriers by enrolling them in online OR training courses from HealthStream. As an IMDA member, you'll receive a discount. Upon completing them, your reps will receive a wallet-sized card provided by AORN and HealthStream. That card is a door-opener. To learn more about the program, visit this URL today: www.healthstream.com/products/sts.htm. To take advantage of the special IMDA discount, go to the "Members Only" portion of the IMDA Website (www.imda.org) and scroll to the box on "Surgical Environment Training."

According to Duke Johns of Medical Specialties, there are several good reasons to sit in on those sessions.

Reason No. 1: By taking in the educational sessions, you get to hear what your customers are hearing. By doing so, you’ll make yourself a better resource to them. Features and benefits are important, sure. But when you hear what your customers are listening to, you can frame your products in a context they understand. You can show them “what’s in it for them” to buy your product.

Reason No. 2: You demonstrate to your customers that you’re interested in them. “Not only are you looking cool, but your customers see you – a peddler – sitting in on their session and they’re thinking, ‘He must really care about me,’” says Johns.

Reason No. 3: You have an opportunity to educate your customers. At a recent state meeting, for example, Johns noted that some speakers were discussing the state of respiratory therapy. “There are things I believe in or want to interject and want [the audience members] to understand,” says Johns. By being there, you have an opportunity to do just that.

Reason No. 4: You get a chance to hear what the competition is saying and to clear up – or at least monitor – any misinformation they might be spreading. At another recent meeting, Johns attended a session in which the speaker dissed some products (some of which Medical Specialties sells) while talking up others (whose manufacturers were paying the speaker as a consultant). Johns spoke directly with the speaker after the presentation, but in the future, plans to publicly challenge such speakers to prove that what they are saying is based on evidence, not opinion.

“If you’re not there, you don’t hear it, you can’t pass judgment, you can’t make comments,” he says. So be there.

Return to top

IMDA Announcement Looking for lines? View a list of all medical devices receiving FDA marketing clearance in March by visiting the FDA Website. You might find a company in need of your expertise.

Earlier this year, Oconee Medical Center in Seneca, S.C., made a decision that’s becoming more popular these days. Not only did the 160-bed hospital switch GPOs – from Amerinet to Premier – but it joined a subgroup within Premier called the WNC Health Network.

WNC is what some industry observers call a regional purchasing coalition or regional aggregation coalition. Essentially, these coalitions are “groups within groups,” which bring individual hospitals and hospital systems together to maximize the buying power of their members. Interestingly, these regional groups are most often formed with the blessing and aid of the big GPOs, usually in an effort by the participants to achieve the very top tiers (and most favorable pricing) of the national contracts.

WNC Health Network, for example, comprises 48 hospitals and health systems representing 55 facilities. By working together with Premier through WNC, member hospitals have collectively saved nearly $46 million since 2001, according to Premier.

Premier has 19 so-called aggregation groups across the country today. Nor is it alone. VHA reports that it has about 30 so-called supply networks, with growing interest among its members. And Amerinet reports growing interest in regional alliances among its members as well.

IMDA members should expect participants’ commitment to these aggregation groups to be high, according to observers. The structure of purchasing coalitions tends to facilitate “stakeholder buy-in to proposed projects and quick implementation,” Premier Purchasing Partners President Mike Alkire tells the Journal of Healthcare Contracting in an upcoming article. “The coalitions [within Premier] have a group structure that includes two sub-committees and a primary materials management committee,” he says. “The sub-committees [are comprised of] clinical and construction facilities professionals, and they research opportunities in their respective areas and present these to the supply chain executives. [The member hospital committees] are very invested in the analyses they conduct and the decisions they make.”

GPO study

Meanwhile, the author of a study funded by the Health Industry Group Purchasing Association reports that GPOs save the U.S. healthcare industry $36 billion annually in price savings and more than $2 billion in savings associated with human resources uncommitted to the purchasing process, such as contracting staff and contract administrators.

Eugene Schneller, Ph.D., principal, Health Care Sector Advances, Scottsdale, Ariz., surveyed 28 hospital systems representing 429 hospitals. The $36 billion in annual GPO direct price savings is distributed as follows:

• $6.8 billion in price savings for hospital pharmaceuticals.

• $8.5 billion for savings on med/surg (non-physician-preference) purchases

• $1.9 billion in savings on cardiology implant purchases, either directly or indirectly by providing members with GPO purchased goods or reference pricing. (More than half of U.S. hospitals and systems use GPO pricing as the benchmark for starting their own negotiations for physician preference items, according to the report.)

• $840 million in savings on orthopedic implant purchases (either directly or indirectly by providing members with GPO reference pricing).

• $17.96 billion in savings to “other clinical products, such as computers, food, janitorial products and office products.

In addition, U. S. hospitals and hospital systems are estimated to have saved $1.8 billion in “human resource savings,” that is, savings attributed to the avoidance of salaries for contracting staff.

To view the entire report, “The Value of Group Purchasing – 2009: Meeting the Needs for Strategic Savings,” go to www.gpossavemoney.org and click on “New Report” in the upper left part of the home page.

Return to top

The term “minimally invasive surgery” is on the brink of climbing to new heights – or depths, as the case may be. Ethicon Endo-Surgery announced that it is the first company to receive an Investigational Device Exemption (IDE) from the U.S. Food and Drug Administration to investigate devices specifically designed for natural orifice translumenal endoscopic surgery (NOTES).

Natural orifice surgery is a surgical procedure in which external incisions are eliminated altogether. Instead, an endoscope is passed through a natural orifice – e.g., mouth or vagina – then through an internal incision in the stomach, bladder, colon or uterus.

Ethicon Endo-Surgery’s study will include up to 40 subjects undergoing either a cholecystectomy (gallbladder removal) or diagnostic peritoneoscopy (exploratory surgery to investigate chronic pelvic pain). Each trial will investigate one of four methods: transgastric (through the mouth) and transvaginal (through the vagina) cholecystectomies, and transgastric and transvaginal diagnostic peritoneoscopies. The four sites participating in the trial are the Northwestern University Feinberg School of Medicine in Chicago, University of California-San Diego Medical Center, Ohio State University Center for Minimally Invasive Surgery and the University of Missouri University Hospital.

Return to top  

Make healthcare cheaper…by making it better, Part 2 It’s time to tackle the big one: insurance By Joe Flower

Editor’s Note: Last month, IMDA Annual Conference keynote speaker Joe Flower wrote about three ways to make healthcare cheaper by making it better – improve end-of-life care, make the prices for healthcare services “transparent,” and bundle healthcare into comprehensive packages or services. This month, he tackles one of the biggest components of all – insurance.

Don’t miss Flower as he delivers his keynote presentation, “Selling Into a Value-Based Healthcare System: Three Hard Steps,” on Monday, June 15, at the IMDA Annual Conference in Charleston, S.C.

II'm going to say something that may surprise you. There are lots of ways to make healthcare cheaper by making it better. It's not like getting your fender fixed. People who use healthcare -- you and me -- have no way to tell what's good and what's not, or even what it really costs. All we know is that we want it to cost less, and be worth more.

On the other hand, people in healthcare have no incentive for doing it cheaper. In fact, they are often rewarded for making decisions that end up driving up costs. When a hospital gets a new MRI imaging machine, its question is, “How do we get people to use it, so we can pay it off?” So of course healthcare costs too much, and gives back too little. We need to change the incentives inside healthcare -- what people work for and what they actually get paid to do. We need to bring healthcare into the 21st Century.

Here are four ideas related to insurance.

1. Go to a single-payer system. People have the impression that having the government pay for anything is automatically inefficient and troublesome. But in healthcare, it's clearly the other way around. In Medicare, for instance, over 95 percent of the money we pay into the system goes to pay for medical care, with only about 5 percent going to administration. That's really remarkable -- 95 cents on the dollar. Private health plans average only about 85 percent for medical care (this is called the medical loss ratio), and often much less – 70 percent or even 60 percent. In some plans less than half of what you pay ever finds its way into medical care. Just the difference between getting back 85 cents on the dollar and getting back 95 cents on the dollar would mean saving something between $60 and $100 billion every year - enough to pay for healthcare for the uninsured.

2. Mandate that plans give back a certain percent of premiums in actual medical care, something that 15 states already do. We could tell the health plans, for instance, that 85 percent of what they take in as premiums must be paid back out in actual medical services. All their overhead, processing, administration, sales, marketing -- and profit -- must come out of the other 15 percent. These costs – that is, what private health plans spend beyond paying for medical care -- are huge. They amount to 7.5 percent of the whole healthcare economy. Germany and Switzerland also have private health plans, but they control the plans' extra costs. They keep them down to only 5 percent, not 7.5 percent. If we could even do just that much, we would save $60 billion a year.

3. Tell health plans to take all comers, whether they have so-called "pre-existing conditions" or not. Health plans currently spend enormous amounts of staff time and effort trying to weed people out, and trying to kick people out of their contracts when they run up large bills. This actually costs plans a lot of extra time and money.

4. If insurers are required to take on all comers, then everyone should be required to have health insurance of some kind, just as drivers must have car insurance. And we should support the working poor in paying for that insurance. How does this save money? By getting everyone to pay into the system, even those who are young and healthy. They'll need it sooner than they think, and meanwhile, we need them to help pay for all the people who use the system a lot because they have diabetes or other chronic diseases.

All four of these ideas actually would make health insurance cheaper by making it better.

Return to top  

IMDA Update Published by IMDA 5204 Fairmount Ave., Downers Grove, IL 60515 Phone:  (630) 655-9280 (866) IMDA-YES (866-463-2937) Fax: (630) 493-0798 Website:  www.imda.org E-mail:  imda@imda.org   Staff Katie Swartz: Executive Director Judy Keel: Executive Vice President Patti Perillo:  Senior Administrator Mary Moran:  Chief Financial Officer Mark Thill, Editor & Communications Director (847) 255-0716 Mitchell Kramer, Legal Counsel (800) 451-7466 Barbara Kramer, Legal Counsel (734) 930-5452 George Ayd, Jr., Insurance Administrator (703) 652-1309         2009-2010 Directors President Kevin Trout, Grandview Medical Resources, Inc. (412) 914-0950 President-Elect Anthony Marmo, Martab Medical (201) 512-1100 Secretary/Treasurer Hal Freehling, Jr., O.E. Meyer Company (419) 609-1633 Chairman of the Board Dave Campbell, PhD, Vital/Med Systems Corporation (303) 660-0888 Directors-at-Large Tom Birmingham, Bay State Anesthesia, Inc. (978) 682-6321 George Howe, Mercury Medical (727) 573-0088 Philip M. Reilly, KOL Bio-Medical Instruments, Inc. (703) 378-8600 Don Reiter, Specialty Respiratory Care, Inc. (818) 717-8807 x19 Bill Schultz, IPV Medical, LLC (760) 212-2769 Past-President Shawn Walker, Bay State Anesthesia, Inc. (978) 682-6321 Manufacturer Representative to Board Tim Beevers, Beevers Manufacturing & Supply (503) 472-9055 The ideas presented in this newsletter may or may not be applicable to your particular situation.  Always consult your tax advisor, attorney or CPA before putting them into effect.