“Armed with a comprehensive model for assessing new technologies and an example of how to apply the model, hospitals and health systems can move forward with confidence in the evaluation process.” — Joe Tomaro, Consulting Director, Advisory Solutions, Vizient

In the realm of musculoskeletal (MSK) care technology, the future isn’t just here — it's taken up permanent residence. For proof, look no further than the latest numbers surrounding robotic joint replacement. In 2020, 11% of domestically performed knee replacement surgeries utilized robotic-assisted technology. By 2030, that number will expand by another 8%, with the number of robotic-assisted knee reconstruction surgeries expected to reach 700,000 globally globally

But as healthcare providers well know, statistics aren’t the only numbers that count. Emerging innovations in the MSK market — including implant technologies, orthobiologics advancements, and apps that improve patient education and experience while undergoing elective surgeries — can no doubt help providers deliver cutting-edge care, but the cost is often far from insignificant and the choices overwhelming.

With multiple stakeholders and a rapidly evolving landscape, it’s important to adopt a proven, consistent model that can help reduce variability and ensure analysts and decision makers consider all perspectives to make the best decision for their organization and patients. That was exactly the impetus for the formation of Vizient’s MSK new technology assessment model, which considers clinical benefits, financial impact and market factors.

“With insight from our industry experts who help healthcare providers evaluate opportunities and make these complex decisions, we have standardized and documented a method for new technology evaluation in MSK," said Joe Tomaro, Vizient consulting director, advisory solutions. “When leveraged properly, this model can help organizations ensure a consistent, methodical approach and the best possible decisions.”

In the latest issue of Medical Device Tech Watch, the Vizient model was applied to a relatively new spine market technology, 3D printed interbody spacers. When it comes to new technologies such as these, Tomaro said, organizations should combine surgeon input with clinical data — such as short-term complication rates, readmission rates, length of patient hospitalizations and patient reported outcome measures (see more below) — and then incorporate the two remaining modules of the Vizient technology assessment model to determine the final cost benefits. Learn more about how the model was applied to 3D printed interbody spacers in the full article.

"Armed with a comprehensive model for assessing new technologies," Tomaro said, "and an example of how to apply the model, hospitals and health systems can move forward with confidence in the evaluation process." 

Clinical benefits:

  • Understand both short- and long-term clinical benefits of a new technology. The technology should ideally decrease the short-term complication rate, readmission rate and/or length of patient hospitalizations. The new technology may also have longer-term benefits, such as decreases in the future revision rates due to better joint replacement. 
  • Consider patient reported outcomes measures (PROMS), including improvement in function and quality of life one year after surgery to evaluate the technology’s long-term effectiveness.

Financial impact:

  • Cost savings that benefit the hospital or surgery center include decreases in operating room time, length of stay, complications and readmissions.  Any technologies that potentially decrease cost or improve patient experience in the post-discharge period may benefit hospitals or surgery centers participating in bundled payment programs.
  • Most new technologies in the MSK service line will not have higher reimbursement than existing products, meaning facilities must generate savings in other areas for margin to remain neutral or positive. In rare instances, certain MSK technologies may qualify for increased reimbursement through the Medicare Add-On Payment program. Since these payments have a limited timeframe of no greater than three years, healthcare organizations might need to conduct extended or repeated financial analysis.

Market considerations:

  • Weigh the benefit of business growth and additional margin from new technologies, such as joint replacement robotics, against the cost of the technology.
  • Analyze the incremental costs of advertising the new technology. Experts are projecting increases in most elective orthopedic procedures, so any incremental growth in procedures due to a new technology must exceed organic market growth. Where technologies such as joint replacement robotics have seen significant market growth over several years, facilities may need to invest in robots to stay competitive.
Published: May 25, 2022