Hospital‐Negotiated Pricing of Cochlear Implants

Bartholomew, Ryan A.; Rathi, Vinay K.; Suresh, Krish; Sethi, Rosh K.V.; Lee, Dong Hoon; Xiao, Roy

doi:10.1002/ohn.280

Otolaryngol.--head neck surg.

2023

DOI: 10.1002/ohn.280

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Hospital‐Negotiated Pricing of Cochlear Implants

Ryan A. Bartholomew

Vinay K. Rathi

Krish Suresh

et al.

Abstract: Access to cochlear implantation can be restricted by financial burden, and little is known about the extent to which cochlear implant (CI) devices prices may vary between hospitals or manufacturers. We performed a cross‐sectional analysis of private payer‐negotiated prices for CI devices. In total, 161 hospitals were analyzed. Prices varied widely across hospitals and between payers. Despite clinical equipoise between manufacturers with regards to CI user outcomes, significant differences in prices were identi… Show more

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2024

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Cited by 3 publications

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Time‐Driven Activity Based Costing of an Annual Canadian Cochlear Implant Program

Liu,

Allenby,

Lee

et al. 2024

Otolaryngol.--head neck surg.

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ObjectiveTo define the cost necessary to run an adult cochlear implant (CI) program, including assessment, subsequent implantation, and follow from the Canadian provincial government perspective.Study DesignTime‐driven activity based costing (TDABC) of a CI program.SettingAdult provincial CI referral center.MethodsClinical scenario pathways were developed and verified with stakeholders. TDABC was then applied to all steps involved in the pathway. Costing was based on all patients referred to the CI program in 2019. All costs were calculated in Canadian (and American) dollars as of 2023.ResultsThis is the first TDABC model of a CI program to the authors knowledge. In 2019, 296 referrals were placed to our CI program and 154 were surgical candidates. The calculated total annual cost for patients referred in 2019 was $4.542 million ($3.365 million USD), or $29,511 ($21,865 USD) per patient implanted. The largest cost contributors to patient cycles were surgical day costs ($23,164 [$17,185 USD] for unilateral, $43,356 [$32,165 USD] for bilateral), switch‐on day costs ($1068 [$791 USD] for unilateral, $1511 [$1120 USD] for bilateral), and audiological assessment costs ($692 [$512 USD]). The highest single cost on the pathway was due to the actual CI device when used. Across other patient steps, the highest costs were related to labor.ConclusionThis TDABC evaluation of a CI program found the annual cost required to meet all referrals was $4.542 million ($3.365 million USD), or $29,511 ($21,865 USD) per patient implanted. The highest single‐cost was associated with the CI device itself.

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Time‐Driven Activity Based Costing of an Annual Canadian Cochlear Implant Program

Liu,

Allenby,

Lee

et al. 2024

Otolaryngol.--head neck surg.

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Implementing a Streamlined Hypoglossal Nerve Stimulator Pathway: Cost, Time to Surgery, and Outcomes

Lenze,

Garcia,

Vijayakumar

et al. 2024

OTO Open

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ObjectiveTo evaluate the costs, time to surgery, and clinical outcomes associated with implementing a streamlined hypoglossal nerve stimulator (HGNS) implantation pathway.Study DesignRetrospective cohort study.SettingSingle tertiary care center in the United States from 2016 to 2023.MethodsPatients with a lack of complete concentric collapse of the velum during volitional snore on in‐office laryngoscopy qualified for the streamlined HGNS pathway. This pathway consisted of confirmatory drug‐induced sleep endoscopy (DISE) followed immediately by HGNS implantation during the same surgical encounter. Outcomes were compared to patients in the traditional pathway (standalone DISE followed by HGNS implantation on a later date).ResultsA total of 68 patients (13 streamlined, 55 traditional) with obstructive sleep apnea who underwent HGNS implantation were included. Patients were predominately male (70.6%) and White (95.6%) and had a mean (SD) age of 63.5 (10.0) years. The streamlined pathway was associated with a significant reduction in both hospital costs (mean difference $9258, 95% confidence interval [CI]: 3690‐14,825; P = .002) and time to surgery (mean decrease of 3.82 months, 95% CI: 0.83‐6.80 months; P = .013) compared to the traditional pathway. Patients in both groups had reduction in apnea‐hypopnea index and Epworth Sleepiness Scale score, with no significant differences in comparisons between groups.ConclusionIn select patients, the streamlined HGNS pathway may expedite time to surgery and reduce hospital costs with comparable clinical outcomes to a traditional 2‐stage pathway. Further research is warranted to validate patient selection and better understand longitudinal outcomes.

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Implementing next-generation sequencing for diagnosis and management of hereditary hearing impairment: a comprehensive review

Tsai,

Hsu,

Chen

et al. 2024

Expert Review of Molecular Diagnostics

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Hospital‐Negotiated Pricing of Cochlear Implants

Cited by 3 publications

References 9 publications

Time‐Driven Activity Based Costing of an Annual Canadian Cochlear Implant Program

Time‐Driven Activity Based Costing of an Annual Canadian Cochlear Implant Program

Implementing a Streamlined Hypoglossal Nerve Stimulator Pathway: Cost, Time to Surgery, and Outcomes

Implementing next-generation sequencing for diagnosis and management of hereditary hearing impairment: a comprehensive review

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