Hui Jenny Chen, MD and Michelle Gabriel, MS, MBA
(This blog is adapted from our recent publication A Roadmap from Idea to Implementation: 3D Printing for Pre-Surgical Application: Operational Management for 3D Printing in Surgery)

A. Revenue Strategies

Although payers currently do not directly reimburse hospitals for the cost of 3D printed models, the use of 3D printing can reduce costs and increase revenue. Increasing income with 3D printing services is not a simple selling/buying transaction. Rather, revenue could come from many sources such as increased efficiencies, increased number of patients served, and increased Medicare reimbursements.

1. Patient Satisfaction

Improving patient understanding of their disease has direct benefits not only to the patient but also to the hospital bottom line margins. Via the 2016 Hospital Value-Based Purchasing program [57], Medicare will adjust hospitals’ payments based on their performance on 4 domains that reflect hospital quality. The patient experience of care domain is weighted as 25% of the Total Performance Score (TPS). That score encompasses 8 important aspects of hospital quality. One of these that is directly relevant is Communication with Doctors, shown as the percentage of patients who reported that their doctors “Always” communicated well. This means doctors explained things clearly, listened carefully, and treated the patient with courtesy and respect. In addition, a second aspect that may be affected by use of 3D printed models is the Overall Rating of the Hospital.

The use of physical 3D representations to significantly increase patients’ understanding of their disease and treatment options can lead to higher patient experience of care ratings, which would lead directly to increased payments to hospitals. The high scoring and improved reputation of a hospital will also drive more patients to choose it over other competing medical centers.

2. Improved patient throughput

Clinical cases continue to show that training, strategizing, and practicing with 3D printed models increases the speed of operations. This can lead to improved throughput in the operating room, which would lead to additional revenue for the hospital.

There is anecdotal evidence that the improved patient understanding of their disease through the use of the 3D printed models reduces the amount of time the doctor spends answering follow-up questions. This frees up doctor time to see additional patients.

3. Specialty focus

Specialty surgeries targeted towards the rare, complex, and often deadly diseases benefit the most from 3D printing, because the technology has provided new insights and opportunities to the surgeons before these high-risk and high-cost surgeries are performed. Some of the examples are well-documented cases in cardiothoracic surgeries. [30,31, 51] However, a simple literature search in Pubmed (http://www.ncbi.nlm.nih.gov/pubmed) on 3D printing surgical applications can show the enormous creativeness demonstrated in every surgical sub-specialty from plastic surgery to interventional/vascular radiology. The number of published cases has compounded in the last few years.

4. Cost Reduction and Avoidance

The case for cost reduction to the medical facility is less clear for pre-surgical applications than it is for applications such as prosthetics and surgical implants.

Payers will be interested in reduced operating time, which can cost up to $180 per minute. Clinical cases demonstrate reduction of operating room time and length of hospital stay, leading to a decrease in risk for hospital acquired infections which are not only detrimental to the patient, but also no longer being reimbursed by Medicare [28].