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The next stage of group purchasing contracts has arrived. Increasing demands of alliances and groups require a more sophisticated response from manufacturers than in the past. Innovative programs, contracts and a thorough knowledge of the group are now required to remain ahead of the competition.
Group purchasing organizations (GPOs) have played a major role in supporting health care delivery in recent years as the healthcare industry has faced stronger economic pressures. Consequently, a position statement was drafted to act as a guideline for a GPO in creating a fiscally responsible, yet unrestricted environment for physicians to select the most appropriate cardiac device for their patients. This cardiac device selection guideline is to be implemented in hundreds of member hospitals but may be of use in non-member hospitals as well. The guideline will only be effective when the physicians or cardiac device caregivers have the knowledge and skills to optimally program and match device therapies and algorithms to individual patient needs.
An important issue in health care today is the cost of essential pharmaceuticals and medical supplies. To control the increase of health care expenses, in 1976 the Gulf Cooperation Council states began to study the idea of establishing a group purchasing programme for pharmaceuticals and medical supplies. This paper demonstrates the elements of the programme, how it works, what obstacles it faces and how other countries can profit from this experience. It also discusses the future of the group purchasing programme in the light of globalization and how the international changes under the World Trade Organization agreements will affect the programme in future.
There are four issues facing provincial GPO's, independent GPO's, health care organizations and vendors: co-operation; commitment; compliance; and competition. Co-operation: Hospitals have traditionally competed with each other for scarce resources and, as a result, have managed their operations in isolation. However, group purchasing provides hospitals willing to work together with an opportunity to significantly increase their purchasing power with vendors, thereby substantially reducing costs. Commitment: The success of GPO's depends on the commitment to contracts by the members. The American experience indicates that commitment of smaller, more focused organizations is easier to control and maintain. Some provincial GPO's have difficulties ensuring commitment from members; therefore, they have not achieved their full potential. Compliance: Hospital compliance with committed volumes negotiated in the corporate contract is essential to ensuring the continued strength of the group's purchasing power. GPO's require mechanisms for ensuring compliance. Smaller GPO's with a common vision and a mutual understanding of the benefits to be realized from compliance will be more successful. Competition: Independent, national GPO's, like Medbuy, may be perceived to pose a threat to provincial GPO's. However, this competition should be viewed positively because it encourages all GPO's to work harder to provide higher quality services that will ultimately benefit the hospital membership. The group purchasing concept is valuable to provide reduced costs to groups through higher volume purchases. Canadian GPO's are evolving and now offer Canadians provincial, interprovincial and independent GPO alternatives. Health care organizations must study these options and decide which alternative would be most beneficial for their particular situation.(ABSTRACT TRUNCATED AT 250 WORDS)
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A formal evaluation process can help healthcare organizations assess the current and/or potential value of a group purchasing organization (GPO). Healthcare organizations should approach a GPO evaluation as if they were entering into a new relationship. The evaluation should include purchasing and financial services, value-added services, and corporate relations/business practices. Healthcare organizations should consider the potential economies of scale and other services offered by a GPO. Healthcare organizations should consider using acceptable substitutes for products currently used or seeking products through alternative sources if doing so achieves greater value.
The purpose of this report is to describe an endomechanical product evaluation and selection program in open surgical procedures as well as laparoscopic surgery designed by hospital representatives of Consorta, Inc. (Rolling Meadows, Illinois), a leading healthcare resource management and group purchasing organization, and Auto Suture/United States Surgical, (a division of Tyco Healthcare Group LP, Norwalk, Connecticut). In this evaluation program, twenty-three facilities of the six Consorta shareholder partners hospitals enrolled surgeons to participate in this nonexperimental observational study of the clinical performance of endomechanical products. Performance characteristics of the endomechanical products produced by Auto Suture that were evaluated in 1145 surgical procedures included clinically acceptable ratings, clinically not acceptable ratings, as well as superior ratings in 2988 product evaluations. In this endomechanical product evaluation, the surgeons found that the endomechanical products were clinically acceptable in 97.7% of the evaluations. In these endomechanical products that were judged to be clinically acceptable, the surgeons gave a superior rating to 20% of the products. It is important to emphasize that the clinically acceptable performance of laparoscopic products (98.1%) was very similar to that of endomechanical performance during open surgery (96.9%). Similarly, a superior rating of laparoscopic products that were judged to be clinically acceptable (22%) was comparable to that of the superior rating for endomechanical products that were considered to be clinically acceptable during open surgery (16%). The general surgeons who performed the majority (64.3%) of the product evaluations for the endomechanical products found an extremely high clinical acceptable rating in 98.2% of the evaluations. The obstetricians and gynecologists who performed the next highest number of procedures, 427 (14.3%), had a clinically acceptable rating of 97.0%. The lowest clinically acceptable rating (86.3%) for endomechanical products was reported by orthopedic surgeons who performed only 2.7% of the evaluations.
The purpose of this report is to describe an expanded suture and needle clinical evaluation program jointly designed by hospital representatives of Consorta, Inc. (Rolling Meadows, Illinois), a leading healthcare resource management and group purchasing organization, and United States Surgical/Davis & Geck Sutures (Division of United States Surgical, Norwalk, Connecticut). In this expanded evaluation program, 42 Consorta shareholder hospitals enrolled 1913 surgeons to participate in Phase II of this non-experimental observational study of the clinical performance of surgical needles and sutures. Performance characteristics of the sutures and needles produced by USS/DG that were evaluated in 25,545 surgical procedures included packaging/ease of opening, needle strength and sharpness, tissue drag, knot security, tensile strength, clinically acceptable determinations, and clinically unacceptable determinations. In these 30-day studies, the surgeons found that the needles and sutures were clinically acceptable in 98.1% of the evaluations. The general, cardiothoracic, and orthopedic surgeons who performed 61.2% of the product evaluations reported that the suture and needle products were clinically acceptable in 98.2% of the evaluations. Nearly half (49.2%) of the evaluations involved the POLYSORB* braided synthetic sutures that received a clinically acceptable rating in 98.2% of the evaluation. The silk suture (SOFSILK*), followed by the monofilament nylon suture (MONOSOF*), were the next most frequently used sutures. The SOFSILK* was found to be clinically acceptable in 99.2% of the evaluations, while MONOSOF* was noted to be clinically acceptable in 98.7% of the evaluations. Surgical needles made by USS/DG Sutures also had a high rating of clinical acceptability (97.9%).
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The Buyers Health Care Action Group (BHCAG) in the Twin Cities has implemented a new purchasing initiative that offers employees a choice among care systems with nonoverlapping networks of primary care providers. These systems offer a standardized benefit package, submit annual bids, and are paid on a risk-adjusted basis. Employees are provided with information on quality and other differences among systems, and most have financial incentives to choose lower-cost systems. Generally, providers have responded favorably to direct contracting and to risk-adjusted payments but have concerns about the risk-adjustment mechanism used and, more importantly, the strength of employers' commitment to the purchasing model.
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