What is the impact of med-tech on the economy?
The impact of medical devices on the cost of health care was one of the topics addressed at this year's National Health Policy Conference, but, typical for such gatherings, no answers were clearly established.
Data collection is not particularly good for establishing the impact of medical technology on costs, partly because upside and downside risks of new devices warp demand and also because reimbursement incentives are misaligned, said Randel E. Richner, BSN, MPH, CEO of the Neocure Group in Newton, MA, a device and drug development consultant.
The payment system offers "inappropriate incentives," including payment schemes that provide different reimbursements for services depending on the site of delivery, Richner said. Medicare, she said, pays hospital outpatient departments $513 for diagnostic colonoscopy and that hospitals account for more than half of all such procedures. By contrast, ambulatory surgical centers, accounting for less than half of such procedures, get about $100 less.
Payers need new technologies that "capture the right information at the right time" in order to rationalize payment, Richner said.
Richner said that, as an entrepreneur, she was "feeling the pain" of health care costs. "I'm writing a check for almost $40,000 a year for the five of us" working at Neocure, she said. The chief culprit for health care inflation "absolutely is not medical technology," Richner asserted.
Regulations can't keep up
Device makers are heavily scrutinized and regulated, dealing with numerous payers and national regulatory bodies from across the globe, she said. However, Richner said she has "empathy for Dan Schultz," the director of the Center for Devices and Radiological Health at the Food and Drug Administration, because regulatory policy can't keep pace with technological change.
Government needs to "avoid the temptation to regulate when events occur before the technology is tested thoroughly," Richner said. When bad news hits, she said, Congress reacts "instantaneously" and "has no tolerance for risk." As for comparative effectiveness, she argued that such data already are coming in from the Centers for Medicare & Medicaid Services (CMS), local Medicare carriers, private payers, and others. She said her own consulting work is more geared toward private payers than toward CMS.
The impact of medical devices on the cost of health care was one of the topics addressed at this year's National Health Policy Conference, but, typical for such gatherings, no answers were clearly established.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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