TforG Care Tracks – Case studies
Introduction of a new product for minimal invasive procedures in spinal surgery
The new all-in product kit for minimal invasive procedures in spinal surgery, treating Lumbar Spinal Stenosis, was designed to allow an outpatient procedure. The advantages included not only reduced hospital stay and recovery time for the patients (a decreased cost for the hospital), but also the fact that this procedure could now also be performed in day centers, as hospitalization was no longer required.
However, the fact that the product allowed an outpatient procedure, also brought along an enormous hurdle: no DRG reimbursement policy existed.
As a result, market penetration was very low and the supplier had to apply for a new DRG reimbursement.
The supplier used the TforG Care Tracks to achieve two main objectives:
- Cost-benefit analysis for the new product vs. the open surgery procedure used
The supplier used the Care Track and TforG analysis to prepare for the DRG reimbursement application. The cost/benefit analysis required for an application was executed using crucial information from the Care Track. Moreover, they learned for each country what was required to get reimbursement, lead time to approval, the different steps involved in the process, etc. - How can the potential of the product be maximized without a new DRG reimbursement
During the two year DRG reimbursement application period, the supplier also wanted to maximize potential within the existing environment.
The TforG Care Track learned them in which countries it was actually possible to include the procedure performed with the new product in the current DRG, if the patient was hospitalized with 1 overnight stay.
The Care Tracks also showed that in other countries the private segment with Out of Pocket funding, was interesting to explore.
Insights generated:
- Optimize impact of external influences like DRG based reimbursements and clinical guidelines
- Cost-benefit analysis of the new technique vs. open surgery