Health systems are trying to drive a wedge between vendors and physicians to better control supply costs.
The systems, however, also are forging closer corporate relationships with vendors to achieve the same end.
Those are the conclusions of a survey of 26 health systems. Westchester, Ill.-based Premier Health Alliance commissioned the survey to see what integrated delivery networks will require of vendors. Preliminary results were presented at Premier's annual "Business Partner" meeting last week. A later report will involve more systems.
The survey shows a movement to limit vendor contact with physicians. Seven of the systems bar commissioned sales representatives from their facilities, and six said they will do so within three years.
Meanwhile, 21 of the systems allow company representatives in their facilities only if their products are under contract or are being considered for contract. That policy will be nearly universal within three years, the survey predicted.
Physicians should expect greater corporate oversight of their use of drugs and supplies. Some 22 of the systems said all their facilities, including hospitals and clinics, have agreed to use the same brands of many products. Standardizing products often allows providers to negotiate better prices from vendors because they can pledge a greater percentage of their purchases.
In three years, nearly every system will require physicians to use standard brands for orthopedic implants, angioplasty catheters, pacemakers, intraocular lenses, contrast media and specialty beds. Those are costly products that, until recently, were bought based on physicians' preferences for certain brands.
Some 23 systems said they will establish a uniform drug formulary within three years. The majority will require physicians to adhere strictly to the formulary recommendations.
Meanwhile, the systems no longer are keeping vendors at a distance from their own operations. Some 23 systems said they expect vendors to help them standardize products, and 22 said they expect vendors to help them use fewer products.
Many systems are testing new ways to pay companies so that their interests match. Eleven systems are paying some companies a set fee per patient day or per procedure instead of paying them for each product used. Such payment forms are intended to motivate companies to help hospitals use fewer products, not more.
Three systems said they have agreements under which vendors provide products for a monthly fee per member in the system health plan. Further details weren't available.
Twenty systems, however, said they expect to have capitated supply contracts within three years. They will buy as much as 40% of their drugs and supplies through those agreements.