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Reimbursement System Stunting MIS Developments

Fri, 06/04/2010 - 5:48am

Two decades after the first successful minimally invasive surgery, today’s techniques and technologies are being held back from providing better patient care and more efficient procedures, according to a report issued today by Cambridge Consultants.  The report analyzes the barriers and opportunities for the future growth of the $15 billion global MIS market, with data collected through input from pre-eminent representatives with backgrounds in imaging and navigation, surgical robotics, regulatory affairs, laparoscopy and endoscopy.

As productivity growth for the hospital industry stagnates at a rate less than half of the general economy, today’s reimbursement coding system is the main culprit limiting radical growth in MIS, states the report. The current coding system, which generally refers to the cost, payment and insurance infrastructure supporting patient care, dictates that devices and procedures in clinical trials must be quick and profitable first, with efficacy and patient care playing secondary roles. 

In addition, despite the need to develop alternatives that can both lower the risk of infection and speed up a patient’s recovery time, the current system still favors the status quo rather than a more in-depth approach that might produce better outcomes. “The existing reimbursement coding system is stifling true leapfrog innovation,” said Andrew Diston, Head of Global Medical Technology Practice, Cambridge Consultants. “Even in today’s challenging economy, it is the long-term, sometimes higher-capital investments that will in the end bring about the improvements that can radically reduce MIS costs and improve patient outcomes. Device makers want codes that reward innovation and patient care rather than short, dispensable income. This reimbursement issue has been hidden under the layers as an afterthought for too long.”

The report, Navigating Surgical Options: The future of minimally invasive surgery, examines market dynamics and drivers for industry growth along with new surgical and technological developments that will advance the MIS market. Including viewpoints from GE Healthcare, Philips Healthcare, Ethicon Endo-Surgery, Covidien, Stryker Instruments, Medtronic, Intuitive Surgical, and Brigham and Women’s Hospital, the report states that reimbursement changes along with the convergence of a more informed patient and advances in surgical technologies will ultimately create better clinical outcomes with a lower risk to the patient.

In addition, the report finds that the growing voice of the informed patient is driving popularity away from traditional curative procedures. Preventative procedures are in turn being driven by this new consumer demand. As an enabler of this new health paradigm of earlier intervention and prevention, MIS can offer lower risk and lower cost procedures as many patients are now requesting their own procedures and access to information earlier in the life of a disease, when healthcare generally costs less. 

The big winners in MIS will be those groups that can embrace this growing consumer market and the new sales channels that have emerged.

The report concludes that technology integration is equally important to the future of the industry. Meanwhile, developing devices and simulators that better integrate imaging and instrumentation – and ultimately real-time diagnostics and therapy – can create more effective surgical procedures. Widespread implementation of “smart” surgical tools will create more efficient and cost-effective surgeries and clinical trials, improving feedback loops for patients and providers, and ultimately, the entire healthcare system.

To request a full copy of the MIS Report, click here.

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