Clinical Orthopaedics and Related Research®

, Volume 470, Issue 4, pp 1054–1064 | Cite as

Value-based Purchasing of Medical Devices

  • William T. ObremskeyEmail author
  • Teresa Dail
  • A. Alex Jahangir
Symposium: Value Based Healthcare



Health care in the United States is known for its continued innovation and production of new devices and techniques. While the intention of these devices is to improve the delivery and outcome of patient care, they do not always achieve this goal. As new technologies enter the market, hospitals and physicians must determine which of these new devices to incorporate into practice, and it is important these devices bring value to patient care. We provide a model of a physician-engaged process to decrease cost and increase review of physician preference items.


We describe the challenges, implementation, and outcomes of cost reduction and product stabilization of a value-based process for purchasing medical devices at a major academic medical center.


We implemented a physician-driven committee that standardized and utilized evidence-based, clinically sound, and financially responsible methods for introducing or consolidating new supplies, devices, and technology for patient care. This committee worked with institutional finance and administrative leaders to accomplish its goals.


Utilizing this physician-driven committee, we provided access to new products, standardized some products, decreased costs of physician preference items 11% to 26% across service lines, and achieved savings of greater than $8 million per year.


The implementation of a facility-based technology assessment committee that critically evaluates new technology can decrease hospital costs on implants and standardize some product lines.


Medical Device List Price Healthcare Technology Price Transparency Industry Relationship 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Chalkidou K, Lord J, Fischer A, Littlejohns P. Evidence-based decision making: when should we wait for more information? Health Aff (Millwood). 2008;27:1642–1653.CrossRefGoogle Scholar
  2. 2.
    Dirschl DR, Goodroe J, Thornton DM, Eiland GW. AOA Symposium. Gainsharing in orthopaedics: passing fancy or wave of the future? J Bone Joint Surg Am. 2007;89:2075–2083.PubMedCrossRefGoogle Scholar
  3. 3.
    Feder BJ. Artificial joint makers settle kickback case. New York Times. September 28, 2007.Google Scholar
  4. 4.
    Hahn RW, Klovers KB, Singer HJ. The need for greater price transparency in the medical device industry: an economic analysis. Health Aff (Millwood). 2008;27:1554–1559.CrossRefGoogle Scholar
  5. 5.
    Institute of Medicine. Medical Devices and the Public’s Health: The FDA 510(k) Clearance Process at 35 Years. Washington, DC: The National Academies Press; 2011.Google Scholar
  6. 6.
    Integrated Health Care Association. Integrated healthcare association medical device value assessment and purchasing (VAP) project: summary report on pilot project, 2006–08. Available at: Accessed September 29, 2011.
  7. 7.
    Ketcham JD, Furukawa MF. Hospital-physician gainsharing in cardiology. Health Aff (Millwood). 2008;27:803–812.CrossRefGoogle Scholar
  8. 8.
    Lerner JC, Fox DM, Nelson T, Reiss JB. The consequence of secret prices: the politics of physician preference items. Health Aff (Millwood). 2008;27:1560–1565.CrossRefGoogle Scholar
  9. 9.
    Marcus RE, Zenty TF 3rd, Adelman HG. Aligning incentives in orthopaedics: opportunities and challenges—the Case Medical Center experience. Clin Orthop Relat Res. 2009;467:2525–2534.PubMedCrossRefGoogle Scholar
  10. 10.
    Merriam-Webster Inc. The Merriam-Webster Dictionary. Springfield, MA: Merriam-Webster; 2005.Google Scholar
  11. 11.
    Obremskey WT, Pappas N, Attallah-Wasif E, Tornetta P 3rd, Bhandari M. Level of evidence in orthopaedic journals. J Bone Joint Surg Am. 2005;87:2632–2638.PubMedCrossRefGoogle Scholar
  12. 12.
    Pauly MV, Burns LR. Price transparency for medical devices. Health Aff (Millwood). 2008;27:1544–1553.CrossRefGoogle Scholar
  13. 13.
    Ranawat AS, Nunley R, Bozic K. Executive summary: value-based purchasing and technology assessment in orthopaedics. Clin Orthop Relat Res. 2009;467:2556–2560.PubMedCrossRefGoogle Scholar
  14. 14.
    Robinson JC. Value-based purchasing for medical devices. Health Aff (Millwood). 2008;27:1523–1531.CrossRefGoogle Scholar
  15. 15.
    US Federal Trade Commission. Letter to Assemblyman Greg Aghazarian: the FTC reviewed California State Assembly Bill 1960. Available at: Accessed April 20, 2011.
  16. 16.
    Wilensky GR, Wolter N, Fischer MM. Gain sharing: a good concept getting a bad name? Health Aff (Millwood). 2007;26:w58–w67.CrossRefGoogle Scholar
  17. 17.
    Wilson NA, Schneller ES, Montgomery K, Bozic KJ. Hip and knee implants: current trends and policy considerations. Health Aff (Millwood). 2008;27:1587–1598.CrossRefGoogle Scholar

Copyright information

© The Association of Bone and Joint Surgeons® 2011

Authors and Affiliations

  • William T. Obremskey
    • 1
    Email author
  • Teresa Dail
    • 2
  • A. Alex Jahangir
    • 1
  1. 1.Department of Orthopaedic Surgery and RehabilitationVanderbilt Orthopaedic Institute Center for Health PolicyNashvilleUSA
  2. 2.Supply Chain-Medical Center Support ServicesVanderbilt University Medical CenterNashvilleUSA

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