Of the many benefits of outsourcing cataract procedures, one often gets overlooked: giving your eye surgeons access to the latest ophthalmic equipment, all the while sidestepping the cost of purchasing and maintaining such big-ticket items as operating microscopes, YAG lasers and phacoemulsifiers. After all, why go to the trouble of paying for new equipment and training your team to use it when an outsourcing company can deliver the same equipment, set it up for you and handle the upkeep? As you'll see, not only can outsourcing make cataract procedures more financially attractive for you to host, it can also make your facility a desirable place for ophthalmologists who demand the very best equipment to perform their cases.

Conserve cash
Gainesville (Ga.) Eye Center performs cataract surgeries twice weekly. Rather than buying expensive equipment to essentially collect dust the other 3 days of the week, the facility pays per case to use equipment, instruments and technicians — along with training and maintenance — supplied at a set rate by its outsourcing partner.

In ophthalmology, the technology is quickly evolving. Gainesville Eye Center recently entered an arrangement to use a vendor's femtosecond laser unit for bladeless cataract surgery. Buying the machine would have set the physician-owned ophthalmology center back about $500,000, says Becky Burnett, RN, BSN, the facility's clinical director. "If we actually purchased that machine outright, it would take a long time to pay off," she says. "Given the number of cataract surgeries we do, I don't know if we would ever reap the benefit of buying it."

The vendor provides 2 on-site certified technicians to maintain equipment and aid in performing cataract procedures as needed, adds Ms. Burnett, noting that this cuts training costs and internal staffing needs for cataract surgeries. Gainesville's arrangement lets them order equipment and supplies from any ophthalmic vendor on a case-by-case basis based on surgeon preferences, all for a fixed fee (the fee is bundled to include IOLs, instruments and training as well as equipment).

Outpace technology
Outsourcing provides access to state-of-the-art technology that might not be economically viable otherwise. Many outsourcing agreements also let centers upgrade equipment as technology advances.

Gainesville Eye Center, for example, is the first facility in Georgia to use the femtosecond laser, says Ms. Burnett. "That's a huge advantage and advertisement for us," she says. "We can promote being the first in the state to get this new technology, and it won't be a huge capital outlay for us."

From a surgical standpoint, her physicians have also benefitted, says Ms. Burnett. "The new laser technology gives us more precision than manual techniques, is much less invasive when removing the cataract and helps improve lens placement," she says. "The laser surgery is safer, more accurate and offers faster recovery."

The center has gotten positive feedback from patients as well. "I had a patient call this morning," says Ms. Burnett, "and tell us that she could see much clearer out of the eye we operated on just yesterday."

Leave it to the experts
Nearly every outsourcing contract includes the services of certified surgical technicians to oversee equipment maintenance and assist in cataract cases as needed. Having additional techs on hand is invaluable for a small, rural hospital like Perkins County Health System, says Faye Johnson, RN, BSN, surgery supervisor at the Grant, Neb.-based facility.

After forgoing cataract surgeries for roughly 3 years, the 20-bed critical access hospital began performing them again this past summer, says Ms. Johnson. The hospital now uses equipment supplied by a cataract surgery equipment and service provider, and relies on one of the company's technicians to set up and maintain equipment, she says.

"I just feel that works better for us. The techs know the machines better than we do," says Ms. Johnson. "And we don't have to send our staff to get trained on this specialized equipment."

The vendor's technicians are also comfortable working with numerous eye surgeons, she adds. "That helps us, because these techs work with different eye surgeons all the time. So they know the different supplies and are more knowledgeable about what surgeons need for these procedures."

Weigh the benefits
At first blush, the economics alone seem to make outsourcing capital equipment for your cataract procedures a no-brainer. But there are more factors that should inform your decision. For example, many contracts require that you perform a minimum number of cataract procedures in order to use the vendor's equipment and services. Determine a number that makes performing the surgeries profitable for your center, and come to a figure that's attainable, says Ms. Burnett.

"For facilities like ours, we stay afloat by doing a solid number of outpatient procedures like cataract surgeries," says Ms. Johnson. "So by increasing the volume of these procedures, we ultimately increase our revenue."