Now manufacturers are facing pushback to that model as hospitals, facing declining reimbursement rates, pressure them to reduce prices on medical supplies and devices while cutting back on pricey technologies that don't produce better clinical outcomes for their patients.
Those dynamics, along with the rising number of physicians employed by hospitals, are pushing devicemakers to alter their sales, marketing and, in some cases, product development strategies to target cost-conscious hospital executives rather than physicians. They also are selling the value behind their devices—for instance, whether a particular product can help reduce hospitalizations—and touting themselves as partners to healthcare providers.
“We've got to look at the continuum of care and see where we (can) deliver some efficiencies and value in a way that helps the provider,” said Jim Mayberry, Boston Scientific Corp.'s vice president of marketing and corporate sales operations.
Hefner said that kind of approach is overdue. “We're entering an era in America medicine that is going to require us to think and act differently—we would say better, faster, cheaper—or else we will be extinct,” he said. “We need partners who can help us rethink our way forward.”
In June, Georgia Regents and Royal Philips announced an agreement in which the 503-bed public teaching hospital committed $300 million in spending over the next 15 years to Royal Philips, which in turn will provide the hospital and associated providers—Children's Hospital of Georgia, Georgia Regents University Cancer Center and other outpatient clinics—with new technology, maintenance and other services. Philips Healthcare is one of the largest manufacturers of imaging systems and patient monitoring technologies.
Hefner's earlier attempts in the 2000s to set up similar partnerships with a number of companies failed, partly because there was not an urgent need at that time for the device industry to operate differently, he said. Even now it's a tough sell. “Could we get other industry leaders to operate that way right now?” Hefner said. “I don't think so. They're interested in talking about it and doing some things around the edges, but not as robustly as (what) Philips and Georgia Regents have crafted.”
But devicemakers say their model is changing and that they are improving surgical procedures that use their devices, developing technologies that reduce hospital visits and complications, and finding new ways to cut out costs that can then lead to lower prices.
Diana Lee, an analyst for Moody's Investors Service, said manufacturers are starting to respond to the greater involvement of hospitals in making buying decisions for medical devices. “All of these things lead to a more competitive situation for the medical devicemakers.”
Some device manufacturers have even started sending their executives, rather than sales representatives, to meet with supply-chain staff before sales reps engage the hospital's physicians. That's happening at Broward Health hospital system in South Florida. “The manufacturers are coming in with new ways to partner not just with the physicians, but the financial folks and the supply chain,” said Brian Bravo, Broward Health's director of corporate materials management and procurement officer.