Cleveland Clinic EVAR graft question

MunoRN, RN · Feb 16, 2017

I sort of doubt that you're going to get a response from someone who sets prices at the Cleveland Clinic, and there is no one single price, different payers negotiate different prices. But Cleveland Clinic does post their chargemaster prices: http://my.clevelandclinic.org/ccf/media/files/Patients/cleveland-clinic-main-charges.pdf

An EVAR stay is typically 8 days for the daily rate pricing on that last, and this doesn't include the endograft itself which is typically about $10,000. It also doesn't include billing by Physicians which may account for the majority of the cost.

solneeshka, BSN, RN · Feb 17, 2017

Sorry, I wasn't clear. I'm not looking reimbursement information or or total cost of stay info or anything like that. I know that no one can give out the prices that they pay for the actual grafts. Just looking for the process that they (or, more likely, their supply chain) followed to come up with whatever the prices are that they are willing to pay for the grafts. Different hospital systems use different methods to set pricing, and even within their own system will use different processes for different kinds of products, particularly high-dollar physician preference items (like EVAR grafts).

brillohead, ADN, RN · Feb 17, 2017

But how would a NURSE be involved in the pricing of anything?

This is an accountant situation, not a nurse situation.

Wile E Coyote, ASN, RN · Feb 17, 2017

But how would a NURSE be involved in the pricing of anything?
This is an accountant situation, not a nurse situation.

18 years ago, my tele floor charge RN used to get a daily list of all 'missed charges' from the previous day. An IV catheter was $18, a bag of fluid was $56 (prices charged to the patient, not the negotiate rate paid by any insurer). Currently, I sit on two different committees that discuss price on every product or device we evaluate.

Now, that doesnt specifically speak to your question, but is in the ballpark.

MunoRN, RN · Feb 17, 2017

18 years ago, my tele floor charge RN used to get a daily list of all 'missed charges' from the previous day. An IV catheter was $18, a bag of fluid was $56 (prices charged to the patient, not the negotiate rate paid by any insurer). Currently, I sit on two different committees that discuss price on every product or device we evaluate.
Now, that doesnt specifically speak to your question, but is in the ballpark.

I think this gets confusing because for some reason there are still some hospitals that track these sorts of things for internal purposes, but there are no longer any payers (insurers, CMS, medicaid) that pay for any of these things individually, all billing is now bundled based on acuity and DRG.

solneeshka, BSN, RN · Feb 17, 2017

I'm a nurse. I'm involved in negotiating prices for our implants. I know what they cost; we use them and I can see very easily what we pay for them. My question was is in regard to a specific other facility, who I'm told uses a different pricing model than we do, hoping to learn more about how they developed that model.

Clinical care isnt isn't the only role that nurses can have. We do all sorts of things, and can add significant value to traditionally non-nursing functions when we step into those roles in the context of healthcare. Vendor contract negotiations, for example. Vendors can't BS me in the way they might be able to BS an accountant (which I also am, BTW) because I've been in the OR with the surgeons who use these items, and I have the relationships with the surgeons to ask them if something is really worth paying a premium over something else. It is one of our surgeons who told me about the pricing model at Cleveland Clinic, which is why I logged on and asked the question.

There are nurses who are not involved in direst clinical care who use allnurses. If they were smart, there would be non-nurses in the healthcare industry who would also use allnurses.

If someone on the board happens to have the info in my original question, that's what I'm looking for. If not, no worries.