Why does it take 2.1% just to send out denial letters? And 4.2 % for other Administrative expenses- what is that? But- they do spend 0.8% on quality improvement. For example- "Other Fees and Business Expenses (3%) - other fees are probably the private jet costs for executives and Cost Containment which really is preauthorization abuses at 2.1%. What is more interesting, are the looney categories in insurance. For every premium dollar spent in America, 17.5% does not go to healthcare it goes to the pockets of insurance companies. You need to add the entire line and THAT is the money taken out of the system by insurance companies. The reader's eyes immediately go to the bottom right where you see, in bold black numbers- 3.6% profit. But, notice how the insurance company line is deeply itemized but the top line is not. The top line supposedly is the line going to direct healthcare and the bottom line is the one going to insurance companies. At first glance, it appears like "facts" that we have seen and gotten used to over and over. They even control the narrative represented by the picture below. The greatest insurance scam ever perpetrated against the American people was and is the daily business practices of insurance companies. Yes? No? #orthopedics #salesexecutives #marketing What I do know is that if every company's TKR system has the same great results and patient satisfaction as every other company's implant, we have implied that we are all the same. I am not an economist, so I don't know the answer. Is that what has happened to TKR pricing? Commodities lack differentiation and, thus, prices for a commodity decline. If a Hospital CEO or CFO concludes that any implant will yield the same great result as any other implant (regardless of technique) then he or she is going to conclude that TKR implants have become a commodity. There is likely to be one million of these cases this year. So what? The image below is a surgeon and his PA about to start a TKR case. mechanical alignment showed no significant differences such that the authors could recommend one method versus the other. A recent meta-analysis of kinematic alignment vs. The literature still lacks a prospective, randomized study proving the benefits of robotics. Some have used mechanical alignment, some have not. Some have been implanted using robotics, some have not. Some have been medial pivot knees, some have not. Being surface-bound, all cellular activity resulting from P-15 Osteogenic Cell Binding Peptide attachment is restricted to the implant surface so bone cannot grow where it doesn’t belong (ectopic bone growth).Clinical Results of TKR & The Impact on Pricing-A Hypothesisĭuring the last 10 years the four major Orthopedic companies and five smaller companies (by sales volume) have all reported excellent clinical results and much improved patient satisfaction with their total knee implants. This unique combination creates a surface-bound “Attract, Attach, Activate” mechanism of action that enhances the body’s natural bone healing process. I-FACTOR ™ Bone Graft is the only biologic bone graft made of a small peptide, P-15 Osteogenic Cell Binding Peptide, bound to an anorganic bone mineral (ABM). Unfortunately, the viability of cells in non-vascularized, processed allogeneic bone grafts (cellular bone matrix) is unknown. Some would suggest that this only occurs when autogenous bone has been implanted immediately or when a bone graft substitute has been enriched with autogenous cells. Where rhBMPs have been engineered to maintain the growth factors, the processing of DBMs causes significant variability in the amount of osteoinductive factors that remain in the final product.Ī bone graft is considered osteogenic if it contains living osteogenic cells that are able to survive in the host environment. Only a bone graft that is preserved with an osteoinductive factor (e.g., members of the transforming growth factor family) can be considered osteoinductive. An osteoinductive bone graft (rhBMP, formulated DBM) is defined as a material that can induce the differentiation of mesenchymal cells into osteoblasts. Resorption time, porosity, and mechanical strength can vary widely in this class of products. Whether natural (allograft, simple demineralized bone matrix) or synthetic (hydroxyapatite, calcium phosphate), structure is key to an osteoconductive scaffold providing a suitable workplace for bone forming cells. The way a bone grafting technology works depends on many factors including the properties of the graft itself.
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