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Supply Chain’s Role in Compliance with IONM Services

The team achieved increased insurance limits and implemented $150K or 15% cost savings.
Health Care Financial Consultant Neuromonitoring
Identify 2

The Challenge

A multi-hospital health system did not have visibility into system Intraoperative Neuromonitoring (IONM) Services. Our cursory look identified the following:

  • Multiple vendors providing similar services
  • Delivery models outside recommended clinical scope of practice
  • Several contentious legal cases on vendor billing practices occurring at a national level
Implement 2

Solutions

Pathstone’s clinical supplies consultants spearheaded a deep-dive review of supplier relationships, delivery models, and industry best practices. The team synthesized all relevant information into three primary opportunities:

  • Compliance: all IONM cases must include a monitoring technologist (IONM-T) and supervising professional (IONM-P) with appropriate hospital credentialing
  • Quality: IONM suppliers must carry appropriate general and products liability given litigation risk
  • Cost: IONM suppliers must provide equitable pricing given hospital geography and case load
Sustain 2

Results

Pathstone formed a cross-functional team of C-Suite, Physician, Supply Chain, and Credentialing stakeholders to triage opportunities in an appropriate manner:

  • Pathstone partnered with a physician team to develop a system standard delivery model in compliance with The American Society of Neurophysiological Monitoring. Pathstone then worked closely with Medical Staff Services to operationalize the delivery model and credential all vendor IONM-Ps at relevant hospitals
  • Pathstone simultaneously conducted an RFP process to address quality and price variation and strengthen contractual terms around fair patient billing. The team achieved increased insurance limits and implemented $150K or 15% cost savings.

Key Takeaways

Supply Chain’s opportunity to elevate organizational compliance standards

While clinical teams own clinical quality, Pathstone will materially contribute by identifying discrepancies and developing policy to elevate quality standards. Pathstone’s involvement enabled Clinical Executives to tackle other priorities while IONM quality advanced.

Supplier insurance as a value lever for comprehensive cost reduction

Supply Chain often focuses on price and key performance indicators during contract negotiations, but insurance coverage may ultimately play a role in total bottom line performance. Supply chain can engage key risk stakeholders and align on standards prior to RFP issue to address all potential cost drivers with potential vendors.

Pathstone affected $120K+ annual savings for the highest-cost program via management fee reduction and program director cost reduction.
Pathstone was able to reduce the overall annual cost of bulk oxygen by nearly 25%.
Staff turnover decreased resulting in $100k of wage savings.
Through collaboration with physicians and the supply chain team, Pathstone achieved an estimated ~$630K in annual savings.