Ventral hernia surgery is never going to be a financial bonanza for outpatient facilities, but does it have to be a losing proposition? Absolutely not. Several administrators we chatted with say the procedure can turn a nice profit, provided you carefully manage the significant number of variables involved.
The notion that ventral hernia repair is a loss leader comes from an oft-quoted 2013 study (tinyurl.com/l96qxyd) from the University of Kentucky College of Medicine, which concluded that "ventral hernia repair is associated with overall financial losses," often resulting, in fact, in "striking net financial losses."
Another fine mesh
An easy trap to fall into, says Debbie Teetzel, MSN, administrator of the Rocky Mountain Surgery Center in Englewood, Colo., is assuming your surgeons think about costs. "Sometimes they do," she says. "But sometimes they're not aware there's other stuff out there. Sometimes their decisions are based on which rep just took them golfing, or which one took them out to dinner. They say, 'I want this product' when they don't really know how much it costs, all they know is they liked the rep. So I do a tremendous amount of financial in-services with doctors."
Get surgeons to agree on a single mesh supplier and then leverage volume into purchasing power, says Michael Pankey, ADN, BA, MBA, administrator of the ASC of Spartanburg (S.C.). "I'll do a lunch with my surgeons," he says. "I'll bring 3 mesh types in, from 3 different suppliers, and I'll try to bring in the 3 lowest-priced meshes I can get my hands on. I put them in front of the surgeons, they look at them, they have discussions about what they like and don't like. And 9 times out of 10 they can come to a conclusion where the vast majority are satisfied with one group of mesh."
That kind of ongoing communication is crucial. "Our MDs and the mesh reps work together and then the chosen products must be on contract pricing," says another administrator.
"Finding a good product that is also cost effective is a challenge," says Kathryn Loretta Rice, BSN, CNOR, administrator of the Gwinnett Surgery Center in Lawrenceville, Ga., "but our doctors have agreed upon a certain mesh and that volume drives the cost down. It's also important to make sure you have a good buying group or GPO."